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DUST OFF: 

ARMY AEROMEDICAL 
EVACUATION 
IN VIETNAM 



Peter Dorland 

I' 

and 

James Nanney 



CENTER OF MILITAR Y HISTOR Y 
UNITED STATES ARMY 
WASHINGTON, D.C., 1982 








Library of Congress Cataloging in Publication Data 

Dorland, Peter, 1946- 
Dust Off. 

Bibliography: p. 

Includes index. 

1. Vietnamese Conflict, 1961-1975 —Medical and sanitary affairs. 2. 
Vietnamese Conflict, 1961-1975 —Aerial operations, American. I. Nanney, 
James, 1945- 

II. Center of Military History (U.S.) III. Title. 

DS559.44.D67 1982 959.704’37 82-8858 

AACR2 


First Printing 


For sale by the Sufterintendent of Documents, U.S. Government Printing Office 

Washington, D.C. 20402 



Preface 

During a tour with The Historical Unit, U.S. Army Medical Depart¬ 
ment, Fort Detrick, Maryland, from 1974 to 1977, Peter G. Dorland,’then a 
captain and a former Dust Off pilot in Vietnam, completed the basic 
research for this book and drafted a lengthy manuscript. In the first seven 
months of 1981, as an editor at the U.S. Army Center of Military History 
(CMH), Washington, D.C., I conducted further research on Dust Off, 
reorganized and redrafted portions of the original manuscript, and added 
Chapter 4 and the Epilogue. 

The authors accumulated a store of debts, both at Fort Detrick and 
Washington. Albert E. Cowdrey, chief of the Medical History Branch 
(CMH), supervised the project, improving the manuscript’s prose and 
organization in many places, and saw that the revision received a review by 
other historians at the Center: Stanley L. Falk, George L. Mac Garrigle, and 
Jeffrey Greenhut. Col. James W. Dunn’s critical eye also improved the 
substance of the book. The final editing and preparation of the book for 
publication was the work of Edith M. Boldan. Arthur S. Hardyman helped 
design the cover and the map. 

Others at the Center who responded to frequent pleas for assistance were 
Charles Simpson, Col. Mary Van Harn, Charles Ellsworth, Geraldine 
Judkins, Mary Gillett, Dwight Oland, Graham Cosmas, Vincent Demma, 
Jeffrey Clarke, and my coworkers in the Editorial Branch. 

Without the help of these many people, Peter Dorland and I could not 
have produced this book. The authors, of course, accept sole responsibility 
for any errors. 

Washington, D.C. JAMES NANNEY 

18 January 1982 


111 


The Authors 

Peter G. Dorland received a bachelor’s degree in biology from Amherst 
College. From April 1971 to April 1972 he served in Vietnam as an Army 
lieutenant flying helicopter ambulance missions for “Eagle Dust Off’ of the 
101st Airborne Division (Airmobile). From 1974 to 1977 he worked on this 
manuscript at Fort Detrick, Maryland, for the Army Medical Department. 
He then returned to flying duties, and is currently commanding, as a major, 
the 247th Medical Detachment at Fort Irwin, California. 

James S. Nanney received his B.A., M.A., and Ph.D. degrees from 
Vanderbilt University. His fields were American diplomatic history and Rus¬ 
sian history. From 1974 to 1980 he worked as a research associate for the 
George C. Marshall Research Foundation, helping Dr. Forrest C. Pogue ex¬ 
amine the postwar career of General Marshall as Secretary of State and 
Secretary of Defense. In 1977-78, he took a year’s leave of absence from the 
Foundation to teach Russian and recent U.S. history at Murray State Univer¬ 
sity, Murray, Kentucky. Since November 1980 he has been a member of the 
staff of the Center of Military History. He is currently working on the up¬ 
dating of American Military History, by Dr. Maurice Matloff, et al. 


IV 


Contents 


Chapter Pagg 

I. THE EARLY YEARS. 3 

Early Medical Evacuation. 4 

Early Aeromedical Evacuation. 6 

The Korean War. 10 

II. BIRTH OF A TRADITION. 21 

The Struggle Begins. 23 

The First Air Ambulance Unit in Vietnam. 24 

Dust Off Takes Form. 28 

Relations with the South Vietnamese. 30 

Kelly and the Dust Off Mystique. 32 

A New Buildup. 38 

The Crisis Deepens . 40 

III. THE SYSTEM MATURES . 43 

Origins of the Air Ambulance Platoon. 44 

The Air Ambulance Platoon Goes to Work. 46 

The Medical Company (Air Ambulance). 49 

The 436th Medical Company (Provisional). 52 

Attleboro. 53 

The 45th Medical Company. 55 

The Buildup of 1967 . 56 

Riverine Operations. 57 

Dak To . 59 

The 54th and the Kelly Tradition. 61 

Dust Off Wins Its First Medal of Honor. 63 

Dust Off in the Saddle. 66 

IV. THE PILOT AT WORK. 67 

The UH-1 Iroquois (“Huey”). 67 

The Hoist. 70 

Evacuation Missions. 74 

Evacuation Problems. 79 

Enemy Fire. 84 

A Turning Point. 88 


V 


































Chapter Page 

V. FROM TET TO STAND-DOWN. 89 

TET-1968. 89 

The Drawdown Begins. 94 

A Second Medal of Honor. 96 

VNAF Dust Off. 98 

Cambodia. 101 

A Medevac in Peril. 102 

Laos. 106 

Papa Whiskey. 110 

Stand-Down and Ship Out. 113 

EPILOGUE. 115 

Statistics . 115 

Doctrine and Lessons Learned. 117 

A Historical Perspective. 121 

BIBLIOGRAPHICAL NOTE. 125 

Articles . 125 

Books and Studies. 127 

INDEX. 129 

MAP. 2 


VI 





















DUST OFF: 

ARMY AEROMEDICAL 
EVACUATION 
IN VIETNAM 








CHAPTER I 


The Early Years 

The small outpost in the Vietnamese delta stood a vigilant watch. 
For the past twenty-four hours guerrilla soldiers had harassed its 
defenders with occasional mortar rounds and small arms fire. A radio 
call for help had brought fighter-bombers and a spotter plane to try to 
dislodge the enemy from foxholes and bunkers they had built during 
the night. But neither the aerial observer nor the men in the outpost 
could detect the Communist soldiers in their concealed positions. At 
dawn the outpost commander called off his alert and reduced the 
number of perimeter guards. Then he led a patrol out to survey the 
area. No sooner had they left their defenses than the enemy opened 
fire. Two of the soldiers fell, badly wounded, and the rest scrambled 
back to the safety of their perimeter, dragging their casualties with 
them. 

While the medical corpsmen treated the wounded, a radio 
telephone operator called their headquarters to the east at Gia Lam. 
There, when the request for medical evacuation came in, the duty 
pilot ran to his waiting helicopter and in minutes was airborne. His 
operations officer had told him that the pickup zone was insecure and 
that gunships would cover him. Since there were few helicopter am¬ 
bulances in the theater, this flight would be a long one: forty-five 
minutes each way. After taking off, the pilots radioed the gunships 
and confirmed the time and place of rendezvous. On his map he trac¬ 
ed his route, out across the paddied landscape, broken only by an oc¬ 
casional village, hamlet, or barbed wire camp. 

Five minutes from the beseiged outpost the flight leader of the 
gunship team radioed the air ambulance that they had him in sight 
and were closing on him. While the ambulance pilot planned his ap¬ 
proach, the gunships made strafing runs over the outpost to keep the 
enemy down. The outpost commander marked his pickup zone with a 
smoke grenade, and the ambulance pilot circled down to it from high 
overhead. As soon as he landed he shouted at the ground troops to 
load the wounded before a mortar hit him. Once the patients were 
secured, the pilot sped out of the area and headed toward Lanessan 
Hospital, radioing ahead to report his estimated time of arrival. Litter 
bearers from the hospital waited to rush the casualties into the 
emergency room as soon as the helicopter touched down. 


4 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


The area where this mission took place was the Red River Delta in 
northern Vietnam. Gia Lam was the airfield serving Hanoi from 
across the Doumer Bridge spanning the Red River. The defenders of 
the outpost were the French in the early 1950s. ^ By the end of 1953 
the French in Indochina were using eighteen medical evacuation 
helicopters. From April 1950 through early 1954 French air 
ambulances evacuated about five thousand casualties. 

In these same years the U.S. Army, which had used a few 
helicopters for medical evacuation at the end of World War II, 
employed helicopter ambulances on a larger scale, transporting some 
17,700 U.S. casualties of the Korean War. Several years later in the 
Vietnam War it used helicopter ambulances to move almost 900,000 
U.S. and allied sick and wounded. The aeromedical evacuation 
techniques developed in these wars opened a new era in the treatment 
of emergency patients. With their ability to land on almost any ter¬ 
rain, helicopters can save precious minutes that often mean the dif¬ 
ference between life and death. Today many civilian medical and 
disaster relief agencies rely on helicopter ambulances. For the past 
thirty years the U.S. Army has played a leading role in the develop¬ 
ment of this new technology. 

Early Medical Evacuation 

Although surgeons often accompanied the professional armies of 
the eighteenth century, the large citizen armies of the early nine¬ 
teenth century, whose battles often produced massive casualties, 
demanded and received the first effective systems of medical evacua¬ 
tion. Two of the officers of Napoleon Bonaparte, the Barons Domini¬ 
que Jean Larrey and Pierre Francois Percy, designed light, well- 
sprung carriages for swift evacuation of the wounded. Napoleon saw 
that each of his divisions received an ambulance corps of about 170 
men, headed by a chief surgeon and equipped with the new horse- 
drawn carriages. Other continental powers quickly adapted the 
French system to their own needs, but the British and American 
armies lagged a full half century in learning the medical lessons of the 
Napoleonic era. 

In the Seminole War of 1835-42 in Florida, the U.S. Army 
Medical Department experimented with horse-drawn ambulances 
and recommended their adoption by the Army. But the Department 
apparently got no response. A few years later experiments were re¬ 
sumed, and a four-wheeled ambulance proved successful in the West. 
But by the outbreak of the Civil War in April 1861 the Army had ac- 

’This incident is related by Valerie Andre, a French Air Force medical pilot who Hew in 
Indochina, in her article “L’Helicoptere sanitaire en Indochine,” L’OfJicier de Reserve, vol. 2 
(1954), pp. 30-31. 


THE EARLY YEARS 


5 


quired more two-wheeled than four-wheeled ambulances, and even 
these were in short supply. In 1862 and 1863 scarce ambulances, poorly 
trained stretcher bearers, and unruly ambulance drivers greatly 
hindered the Medical Department’s efforts to care for the wounded. 
Ambulances were so scarce that after the first major battle of the war at 
Bull Run (21 July 1861) many of the 1,000 Union wounded depended 
on friends and relatives to pick them up in a family carriage. Many 
more simply straggled the twenty-five miles back to Washington on 
foot. Three days after the battle hundreds of wounded still lay where 
they had fallen. The stretcher bearers consisted almost entirely of 
members of military bands who had been assigned the duty. As one 
historian noted, “...scrubbing blood-soaked floors and tables, dis¬ 
posing of dirty scabby bandages and carrying bleeding, shell-shocked 
soldiers had nothing to do with music, accordingly the impressed musi¬ 
cians fled the scene.” 

At the second battle of Bull Run (29 August 1862) the large number 
of civilian drifters hired by the Quartermaster Corps to drive the am¬ 
bulances simply fled the scene at the first few shots. The Surgeon 
General quickly rounded up about two hundred more vehicles from the 
streets of Washington and accepted civilian volunteer drivers, who proved 
to be worse than the first lot. Many broke into the medicine cabinets on the 
ambulances, drank the liquor supply, then disappeared. Those who made 
their way to Bull Run were found stealing blankets and other provisions, 
and some even took to rifling the pockets of the dead and dying. 

Over the course of the war, however, the Union system markedly 
improved, thanks to the efforts of Maj. Jonathan Letterman, Medical 
Director of the Army of the Potomac. Letterman recommended sweep¬ 
ing reforms in the ambulance system and the creation of an orderly 
group of medical clearing stations to the immediate rear of each bat- 
tlefront. The mission of the ambulances was to bring all casualties to the 
clearing stations as rapidly as possible. The station would then sort the 
casualties, a process known as triage. As soon as possible the surgeons 
went to work on the serious casualties whom they deemed savable and 
sent them to hospitals in the rear. The most seriously wounded were 
often set aside, many to die before they reached the operating table. The 
lightly wounded were treated later and retained near the front. Two 
goals suffused Letterman’s new system: to reduce the time between 
wounding and lifesaving (definitive) surgery, and to evacuate a casualty 
no farther to the rear than his wounds demanded. This would result in a 
hierarchy of medical services, a chain of evacuation that carried a patient 
to more specialized care the farther he moved from the front. 

On 2 August 1862 Maj. Gen. George B. McClellan ordered that 
Letterman’s plan be placed into effect in the Army of the Potomac. 
Ambulances were to be used only for the transport of sick or wounded 
soldiers. Stretcher-bearers and hospital stewards were to wear distinc- 


6 


DUST off: army arromedical evacuation in vip:tnam 


tive insignia on their uniforms. Ambulances were to move at the head 
of all wagon trains, not the rear. Only medical corpsmen were to be 
allowed to remove the wounded from the battlefield. Although am¬ 
bulances, horses, and harnesses were to be under division control, all 
ambulance drivers were to be under Medical Department control, 
trained for their work, and not allowed to assume other duties such as 
assisting surgeons in the field hospitals. They were also expected to be 
of proven good character. In March 1864 President Lincoln approved 
a congressional act creating a uniformed Ambulance Corps, based on 
Letterman’s plan, for the entire Army of the United States. 

Although the Ambulance Corps was disbanded at the end of the 
war, it had served remarkably well when it was needed. The Medical 
Department during the war had never overcome serious problems in 
the supply of medicine and the construction of field hospitals. But its 
numerous horse-drawn ambulances had effectively removed the 
wounded from the battlefields, even during the massive conflict at 
Gettysburg. 

In the Spanish-American War and World War I, the U.S. Army 
had to relearn many of the medical lessons of the Civil War. By 
World War I ground evacuation of casualties could be accomplished 
by motor-driven ambulances, but the increased speed was offset to 
some degree by limited road access to the widely dispersed front lines 
in France and the Low Countries. World Wars I and II showed that 
automotive transport, while effective for backhauls from clearing sta¬ 
tions to field hospitals and evacuation hospitals, was of limited value 
in evacuating casualties from the spot where they fell. 

Early Aeromedical Evacuation 

The first aeromedical evacuation occurred in the Franco-Prussian 
War of 1870-71. During the German seige of Paris, observation 
balloons flew out of the city with many bags of mail, a few high- 
ranking officials, and 160 casualties. Thirty-three years later at Kitty 
Hawk, North Carolina, Wilbur and Orville Wright proved that 
manned, engine-powered flight in heavier-than-air craft was actually 
possible. In 1908 the War Department awarded a contract to the 
Wright Brothers for the Army’s first airplane, and in July 1909 
accepted their product. 

Two enterprising Army officers quickly noted the medical poten¬ 
tial of such aircraft. At Pensacola, Florida, in the autumn of 1909, 
Capt. George H. R. Gosman, Medical Corps, and Lt. Albert L. 
Rhoades, Coast Artillery Corps, used their own money to construct a 
strange-looking craft in which the pilot, who was also to be a doctor, 
sat beside the patient. On its first powered flight the plane crashed into 
a tree. Lacking the funds to continue the project. Captain Gosman 


THE EARLY YEARS 


7 


went to Washington to seek money from the War Department. He 
told one conference: “I clearly see that thousands of hours and 
ultimately thousands of patients would be saved through use of 
airplanes in air evacuation.” But his audience thought the idea im¬ 
practical. In May 1912 other military aviators recommended the use 
of air ambulances to the Secretary of War, but the War Department 
still thought airplanes unsuitable for such a mission. During World 
War I Army Aviation grew steadily, but its planes served as air am¬ 
bulances only sporadically. 

As they had with ground ambulances, the French pioneered the 
use of airplanes as ambulances. During maneuvers in 1912 an 
airplane helped stretcher parties on the ground locate simulated 
casualties. The French then designed a monoplane with a box-like 
structure under its fuselage for moving casualties to field hospitals. In 
October 1913 a French military officer reported, “We shall revolu¬ 
tionize war surgery if the aeroplane can be adopted as a means of 
transport for the wounded.” During World War I the French did 
occasionally move the wounded by airplane, especially in November 
1915 during the retreat of the Serbian Army from a combined German, 
Austrian, and Bulgarian attack in Albania. Although the type of air¬ 
craft used in Albania was adequate in this isolated emergency, it was 
hardly fit for routine use on the Western Front. 

For the rest of the war the French Army gave little attention to 
aeromedical evacuation; they had too many casualties and too few 
aircraft to be concerned with it. But one French military surgeon. Dr. 
Eugene Chassaing, managed to keep the idea alive. When he first 
asked for money to build air ambulances, one officer responded, “Are 
there not enough dead in France today without killing the wounded in 
airplanes?” Despite such criticism, Chassaing acquired an old 
Dorland A.R. II fighter and designed a side opening that allowed two 
stretchers to be carried in the empty space of the fuselage behind the 
pilot. After several test flights of the craft, he was permitted to place six 
such aircraft into operation. In April 1918 two of these planes helped in 
the evacuations from Flanders, but the fighting grew so intense there 
that French higher authorities would not sanction continued use of the 
planes. Late in 1918 Dr. Chassaing received permission to convert 
sixty-four airplanes in Morocco into air ambulances, and all were 
used in that country in France’s war against Riffian and Berber 
tribesmen in the Atlas mountains. The French experimented with air 
ambulances throughout the interwar period. 

By the end of World War I the U.S. Army had also begun to re¬ 
examine its position on air ambulances. In 1920 the Army built and 
flew its first aircraft designed as an air ambulance, the DeHavilland 
DH-4A, which had space for a pilot, two litter patients, and a medical 
attendant. In 1924 the Army let its first contracts for air ambulances. 


8 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


and in the ne>^t few years it occasionally used its air ambulances to pro¬ 
vide disaster relief to the civilian community. In April 1927, after a tor¬ 
nado struck the small town of Rocksprings, Texas, the Army sent eigh¬ 
teen DH-4 observation planes, two Douglass transports, and a Cox- 
Klemin XA-1 air ambulance. These planes flew in physicians and sup¬ 
plies to treat 200 injured citizens, some of whom the Cox-Klemin then 
flew out to more sophisticated medical care in San Antonio. 

The decade after the war also saw the development of rotary-wing 
aircraft. In December 1928 the United States received from France its 
first sample of a rotary-wing aircraft —the autogiro, which used one 
motor-driven prop)eller for forward motion and another wind-driven 
propeller for vertical lift. By 1933 one U.S. manufacturer had design¬ 
ed an autogiro ambulance to carry a pilot and three patients, two 
recumbent in wire basket (Stokes) litters, and one sitting. In the 
December 1933 issue of the Military Surgeon, Lt. Col. G. P. Lawrence 
foresaw the military uses of this air ambulance. Since the autogiro 
could not hover, rough terrain, forests, and swamps would still re¬ 
quire ground evacuation of casualties. But autogiros working from 
nearby landing areas could backhaul the casualties to medical sta¬ 
tions. The advantages seemed indisputable: 

Autogiros, not being limited by roads, would find more frequent 
opportunities to open advanced landing posts than would motor ambulances. 
They could maneuver and dodge behind cover so as to make hits by enemy 
artillery quite improbable. At night they could potter around in the dark, un¬ 
disturbed by aimed enemy fire, until they accurately located the landing 
place, outlined by ordinary electric flash lights in the hands of the collecting 
company, and then land so gently that the exact estimation of altitude would 
be immaterial. 

In 1936 the Medical Field Service School at Carlisle Barracks, Penn¬ 
sylvania, tested the medical evacuation abilities of the autogiro. 
Though the results were promising, the Army’s budgetary problems 
prevented funding a rotary-wing medical evacuation unit. 

World War II brought the first widespread use of fixed-wing air¬ 
craft for military medical evacuation. In May 1942 the Army Medical 
Service activated the first U.S. aeromedical evacuation unit, the 38th 
Medical Air Ambulance Squadron, stationed at Fort Benning, 
Georgia. The war also stimulated further research on rotary-wing air¬ 
craft, both in Germany and the United States. Although Allied bomb¬ 
ing raids destroyed the factories that the Germans intended to use for 
helicopter production, research and development in the United States 
proceeded apace. On 20 April 1942 Igor Sikorsky staged a successful 
flight demonstration of his helicopter. By March 1943 the Army had 
ordered thirty-four Sikorsky helicopters, fifteen for the U.S. Army Air 
Forces, fifteen for the British, and four for the U.S. Navy. These and 


THE EARLY YEARS 


9 


later versions of the Sikorsky could be quickly converted to air 
ambulance use by attaching litters to the sides of the aircraft. 

Tests at the Army Materiel Center in the summer of 1943 sug¬ 
gested that the helicopter could be an effective air ambulance. On 13 
August 1943 the Army Surgeon stated that he intended to fill the need 
for a complete air evacuation service in combat zones by employing 
helicopters, regardless of terrain features, as the only means of 
evacuation from front lines to advanced airdomes. Further successful 
tests of the litter-bearing helicopter in November 1943 supported his 
decision. But helicopters were not yet abundant, and the Surgeon’s 
plan came to nothing. 

The helicopter nevertheless managed to prove its value as a device 
for rescue and medical evacuation from forward combat areas. In late 
April 1944, Lt. Carter Harman, one of the first Army Air Forces 
pilots trained in helicopters at the Sikorsky plant in Bridgeport, Con¬ 
necticut, flew for the 1st Air Commando Force, U.S. Army Air 
Forces, in India. On 23 April he took one of his unit’s new litter¬ 
bearing Sikorskys to pick up a stranded party with casualties about 
twenty-five kilometers west of Mawlu, Burma. When he returned to 
India he had flown the U.S. Army’s first helicopter medical evacua¬ 
tion (medevac) mission. Soon helicopters became an item in high de¬ 
mand. Maj. Gen. George E. Stratemeyer, commander of the Eastern 
Air Command, requested six of them for the rescue of five of his pilots 
who had crashed in inaccessible areas and for similar rescue missions. 
In the spring of 1945 helicopters evacuated the sick and wounded of 
the 112th Regimental Combat Team and the 38th Infantry Division 
from remote mountain sites on the island of Luzon in the Philippines. 

Most evacuation from the front lines in World War II, however, 
was by conventional ground ambulance. The Army Medical Service 
did improve its services, greatly reducing the mortality rates from those 
of World War I. New drugs, such as penicillin and the sulfonamides, 
and the stationing of major surgical facilities close to the front line, 
saved hundreds of thousands of lives. Airplanes evacuated over 1.5 
million casualties, far more than in World War I, but this role was 
largely limited to transporting casualties from frontline hospitals to 
restorative and recuperative hospitals in the rear, rather than from the 
site of wounding to life-saving surgical care. At the end of the war Army 
aeromedical evacuation still lacked a coherent system of regulations 
and a standing organizational base. Before it could acquire these. Army 
aviation would have to survive the upheaval attending the creation of 
the United States Air Force. 

The National Security Act of 1947 established the United States 
Air Force as a separate military arm and at the same time stripped the 
Army of most of its aircraft, leaving it only about two hundred light 
planes and helicopters. The general mission of Army aviation was 


10 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


limited to furthering ground combat operations in forward areas of 
the battlefield, a mission that fortunately encompassed responsibility 
for emergency aeromedical evacuation from the front. However, 
when the Korean War opened three years later, the Army Medical 
Service still had no helicopter ambulance units. 

The Korean War 

The Korean War resulted in a rapid, new buildup of American 
military forces, which had been precipitously reduced after World 
War II. This was no less true for the Army Medical Service than for 
other U.S. military agencies. At first, in July 1950, only a single 
evacuation hospital and one Mobile Army Surgical Hospital (MASH) 
supported all U.S. forces in Korea. By the end of the year these 
medical resources had grown to four mobile surgical hospitals, three 
field hospitals, two 500-bed station hospitals, one evacuation hospital, 
and the Swedish Red Cross Hospital near Pusan. The medical 
buildup was timely, for between 7 July and 31 December 1950 United 
Nations forces suffered nearly 62,000 casualties. Medical support ex¬ 
panded even further in 1951. 

The Korean War resulted in the first systematic use of helicopters 
for evacuation of casualties from the battlefield. The rugged, often 
mountainous terrain and the poor, insecure road network in wartime 
Korea made overland movement extremely difficult. Transport of 
wounded and injured ground troops from the front line rearward by 
litter bearers or jeep ambulances seriously aggravated the patient’s 
condition, caused deepened shock, and often produced fatal com¬ 
plications. Just before the war broke out Lt. Gen. Walton Walker, the 
Eighth U.S. Army, Korea (EUSAK) commander, told his senior 
surgeon that in event of hostilities he wanted mobile surgical hospitals 
placed as close to the front lines as possible. During the war the mobile 
surgical hospitals, stationed from five to forty kilometers behind the 
front, served as the main destination of ground and air ambulances 
bringing casualties from clearing stations at the front. Most of the 
casualties arrived in ground ambulances, but 10 to 20 percent were 
brought by helicopters. The Air Force and Navy also used helicopters 
for medical evacuation, but the Army’s helicopter ambulance 
detachments carried the great majority of the war’s helicopter evacuees. 

The Air Force, however, pioneered the use of helicopter 
ambulances in Korea. In July 1950, just after the war broke out. 
Helicopter Detachment F of the Air Force’s Third Air Rescue 
Squadron began to receive requests for evacuation of forward Army 
casualties in areas inaccessible to ground vehicles. Col. Chauncey E. 
Dovell, the Eighth Army Surgeon, arranged a test of the Third Air 
Rescue Squadron’s H-5 helicopters in the courtyard of the Taequ 


THE EARLY YEARS 


11 


Teachers’ College. On 3 August he and Capt. Oscar N. Tibbetts, the 
squadron’s commander, met at the college and examined one of the 
H-5’s. A Stokes litter fit into the compartment of the H-5 very well, 
but the handles of the standard Army litter had to be cut off. With two 
patients and Colonel Dovell on board, the H-5 lifted off, easily 
cleared the surrounding telephone poles and buildings, and returned 
for a perfect landing. Colonel Dovell asked to see a long flight, so the 
pilot flew him and the two patients out to the 8054th Evacuation 
Hospital at Pusan, 100 kilometers away. On 10 August, at Colonel 
Dovell’s request, Lt. Gen. Earle E. Partridge, commander of the Fifth 
Air Force, authorized the use of these and other Air Force helicopters 
for frontline evacuations. The Air Force continued to evacuate the 
Army’s frontline casualties until the end of the year, allowing the Army 
time to organize and ship to Korea its own helicopter detachments. 

Late in the year the Army deployed four helicopter detachments 
to Korea. These units, each authorized four H-13 Sioux helicopters, 
contained no medical personnel, but were under the operational con¬ 
trol of the EUSAK Surgeon. Each was attached to a separate mobile 
surgical hospital, with a primary mission of aeromedical evacuation. 
The crewmembers drew their rations and quarters from the MASH, 
and their aircraft parts and service from wherever they could be 
found. The 2d Helicopter Detachment became operational on 1 
January 1951; the 3d, later in January; and the 4th, in March. The 
1st Helicopter Detachment, which arrived in February, never became 
operational because commanders transferred all of its aircraft to other 
nonmedical units. At the height of the Korean conflict the three 
operational helicopter detachments controlled only eleven aircraft. 
But by the end of the war they had evacuated about 17,700 casualties, 
supplemented by a considerable number of medevac missions per¬ 
formed by nonmedical helicopters organic to division light air sections 
and helicopters of Army cargo transportation companies. Marine and 
Air Force helicopters had also made a sizable number of frontline 
evacuations. 

The independence and therefore the value of the air ambulance 
units increased after the introduction of detailed standard operating 
procedures. Typical of those adopted by the detachments was the list 
that Lt. Col. Carl T. Dubuy, commander of the 1st Mobile Army 
Surgical Hospital, drew up in early February 1951. Evacuation re¬ 
quests were to be made only for patients with serious wounds, or 
where surface transport would seriously worsen a casualty’s injuries. 
The helicopters would be used strictly for medical evacuation and 
reconnaissance, and would not be used for command, administrative, 
or tactical missions. Each request for a helicopter was to include a 
clear and careful reading of the coordinates of the pickup site. The 
ground commander was to try to find the lowest pickup site around. 


369-454 0-82 


2 


12 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


to ease the strain on the minimally powered H-13 helicopters that 
performed the bulk of medical evacuations in Korea. A request was 
not to be made for a landing zone subject to hostile fire; if trouble did 
develop, the men on the ground were to wave off the helicopter. 
Dubuy recommended the use of colored panels to form a cross to 
mark the pickup site, and he also favored some indicator of wind 
direction and velocity, such as grass fire. He suggested that if the 
helicopter flew past the pickup zone without recognizing it, the 
soldiers on the ground should fire flares or smoke grenades to attract 
the pilot’s attention. (The aircraft had no radios.) Colonel Dubuy sent 
these recommended procedures to the commanding general of the 7th 
Infantry Division, which the 1st Mobile Army Surgical Hospital then 
supported, but the division afforded the list only a haphazard 
distribution. 

In January 1951 all four pilots of the 2d Helicopter Detachment 
took part in a mission that, although it violated the precept that 
helicopters would not be flown within range of enemy weapons, saved 
several lives. On the morning of 13 January, Capt. Albert C. 
Sebourn of the 2d Detachment received an urgent request for air 
evacuation from a unit at a schoolhouse surrounded by a large 
Chinese Communist force near Choksong-ni. The unit was a Special 
Activities Group (SAG), an elite, battalion-size organization of air¬ 
borne and ranger-qualified soldiers. Their only defensive perimeter 
was the border of the one acre schoolyard. A MASH doctor had been 
asking for a ride in a helicopter. Sebourn put him in the right seat and 
then flew to the coordinates of the request. After landing in the 
schoolyard, Sebourn shut down the helicopter. As soon as he and the 
doctor climbed out, a mortar round landed near the right side of the 
helicopter, damaging it but not injuring anyone. Both men ran into 
the schoolhouse, where the commander of the SAG unit explained 
that he had numerous casualties and wanted the helicopter to bring in 
ammunition on its return flights from the hospital. When Sebourn " 
tried to restart his aircraft, he found that the battery was dead; he and 
the doctor stayed at the school overnight. 

When Sebourn did not return to the 2d Detachment’s base after 
several hours, Capt. Joseph W. Hely checked back through Eighth 
Army channels. The request had been quite old when the 2d Detach¬ 
ment received it: it had been routed through Tokyo. Eighth Army 
asked Hely whether he would fly ammunition out to the beleaguered 
force, and he assented. With ammunition in both his aircraft’s litter 
pods, he tried to fly out, but heavy snowfall made him postpone the 
flight until the weather improved. Next morning, when he reached 
the area, he noticed tracers from enemy machine guns trying to shoot 
him down. He spiraled down into the schoolyard, unloaded the am¬ 
munition, gave the battery in Sebourn’s helicopter a boost, and then 


THE EARLY YEARS 


13 


loaded two patients in his own craft. He spiraled out to escape the 
enemy fire again and Sebourn followed him. 

Later that day two other 2d Detachment pilots joined Hely in two 
more flights to the schoolyard, carrying food and ammunition to the 
SAG unit and casualties back to the hospital. Enemy ground fire 
harassed each entry and exit at the schoolyard. On leaving the school 
for the last time just before darkness, Hely radioed an Air Force 
fighter and marked the perimeter for its strike. The next morning the 
2d Detachment made a final evacuation from the schoolyard before 
the SAG unit withdrew. Captains Hely and Sebourn won 
Distinguished Flying Crosses for their work. 

The communications net used to route and obtain approval of a 
ground commander’s request for such a medevac mission was 
laborious at best, especially early in the war. The request usually 
originated at a casualty collecting station in the field or at a battalion 
aid station. Then it was relayed by radio or telephone to the division 
surgeon, then to the corps surgeon, and finally to the Eighth Army 
Surgeon, who decided if the mission was valid. If he approved, the 
approval passed back down the ladder to the helicopter detachment 
attached to the hospital supporting the corps area. This process often 
delayed a mission for hours, and sometimes it led to a cancellation 
because the casualty had already died. Some procedures, though, 
helped speed the response time of the helicopters. Stationing a mobile 
surgical hospital and its helicopter detachment close to the front line, 
usually some ten to forty kilometers behind it, reduced the response 
time. Eventually the Eighth Army Surgeon ceded mission approval 
authority to the corps surgeons, who had direct communications with 
the mobile surgical hospitals, thereby eliminating one level in the 
three-tiered approval structure. 

To improve the communications and speed the response, the 
helicopter detachments began the practice of siting their aircraft in the 
field at clearing stations near the tactical headquarters just behind the 
front lines. These one-aircraft field standbys ensured ready and rapid 
transportation of the critically wounded to mobile surgical hospitals. 
But this solution produced another problem. Since the helicopters 
themselves carried no radios, an aircraft that was field-sited with a 
combat unit that had a poor radio linkup with other combat units in the 
Corps zone could not respond rapidly to sudden fighting in other areas. 
The absence of radios in the aircraft also precluded any air-ground 
communication and made necessary the use of smoke signals and hand 
gestures to ensure the safe completion of a mission. In the first months 
of the war not even the detachment headquarters had radios. When 
available, they helped immensely by freeing the detachments from 
their dependence on Army switchboards and landlines. 

Several times division commanders tried to obtain the assignment 


14 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


of helicopters to specific combat units for evacuation missions (direct 
support). For instance, the 3d Infantry Division, with an indorsement 
from I Corps, requested its own air ambulance; I Corps wanted to 
give each division its own air ambulance. But EUSAK headquarters 
denied the request because there were not enough helicopters to pro¬ 
vide such individualized coverage, and the current area and standby 
coverage was working adequately. 

Many other problems in this new system proved intractable. The 
most serious came from the constant need to repair the helicopter. 
The sluggishness of the Air Force, the Army’s aviation procurement 
agency, in meeting Army aviation’s supply needs created a backlog of 
requests for helicopter parts and components. Just as American in¬ 
dustry at the start of World War II was unable to fill all the Army’s re¬ 
quests for airplanes, so at the start of the Korean War it was not 
geared for helicopter production. The fine tolerances required 
because of the many rotating and revolving parts in a helicopter, and 
the limited commercial potential for the craft, made American aircraft 
manufacturers reluctant to devote their resources to such a chancy in¬ 
vestment. When production did increase, a serious problem arose in 
transporting the vast quantities of war materiel from the States to 
Korea. All of these problems adversely affected the supply of spare 
parts, fuel, and even aircraft. By late 1952 the eleven air ambulance 
helicopters in Korea had to compete with about 635 other Army 
nonmedical helicopters for whatever resources the American aircraft 
industry could provide. 

Parts shortages in the field accounted for the loss of much valuable 
flying time in all Army aviation units in Korea, more so than any 
other problem. In a three month period in 1952 the 8193d Army Unit 
lost about one-third of its potential aircraft days because of parts short¬ 
ages. This resulted in lives lost because the unit was unable to respond 
to all evacuation requests. The 8193d commander, Capt. Emil R. 
Day, requested that a fifth helicopter be assigned to each of the 
MASH helicopter detachments, but this was not done. In allocating 
parts the Air Force favored its own fighters and bombers over the 
Army helicopters. Supply personnel in the States seemed to have little 
awareness of the cost in human life of returning supply requests for 
editorial changes, explanations of excess requirements, and “propef’ 
item descriptions. Harry S. Pack, in an evaluation of the problems of 
helicopter evacuation in Korea, aptly criticized the support system: 

The basic concept of the employment of the helicopter in the Army.. .is 
its increased speed over other forms of transport currently in use in the 
movement of personnel and materiel. Therefore, it is only logical that the en¬ 
tire helicopter program, including maintenance and supply procedures, 
should follow the same philosophy of speed and mobility to ensure receiving 
maximum value from the helicopter. 


THE EARLY YEARS 


15 


The focal point of these supply problems was the Bell Aircraft 
Corporation’s H-13 Sioux helicopter, which performed almost all aero- 
medical evacuations in Korea. Powered by a Franklin engine, it sported 
a large plexiglass bubble over the top and front of the cockpit. It could 
transport a pilot and one passenger, and two patients on external litters. 
Although Bell Aircraft sent some of its test pilots to Korea to help the 
Army pilots obtain maximum performance from the H-13, the aircraft 
simply had not been designed for medical evacuations in mountainous 
terrain. The H-13’s standard fuel capacity could not keep the aircraft 
aloft the two or more hours that many evacuation flights took. The pilots 
had to either fuel at the pickup site or carry extra fuel in five-gallon cans. 
The cans could be carried in the cockpit or, more safely, strapped to the 
litter pods and left at the pickup site. Also, since the battery in the H-13 
was not powerful enough to guarantee restarting the aircraft without a 
boost, the pilots often practiced “hot refueling” in the field. Although 
dangerous, the practice seemed safer than being unable to restart the air¬ 
craft near the front line. 

Because the H-13D’s the pilots flew had no instrument or cockpit 
lights and no gyroscopic attitude indicators, most evacuation missions 
took place in daylight. But extreme emergencies sometimes prompted 
the pilots to complete a night mission by flying with a flashlight held 
between their legs to illuminate the flight instruments. The expedient 
barely worked, because the bouncing, flickering beam of the flashlight 
often produced a blinding glare. 

When the first Army aeromedical unit in Korea, the 2d Helicopter 
Detachment, arrived at the end of 1950 and put its equipment in 
working order, it still could not declare itself operational, because the 
H-13D’s lacked litter platforms, attaching points on the helicopters, 
or even litters. The unit quickly received permission to fit platforms 
on the skid assemblies so that litters could be mounted on either side 
of the fuselage. When the EUSAK Aviation Section failed to obtain 
litters for the detachment, its commander. Captain Sebourn, turned 
to the Navy hospital ship in the Inchon Harbor. The Navy people 
gave him eight of their metal, basket-like Stokes litters. The detach¬ 
ment then had to find covers for them to protect the patients from the 
elements and secure them to the pod. Lt. Joseph L. Bowler took the 
litters to Taegu, found some heavy steel wire, and then had a welder 
at a maintenance company fashion a lid with a plexiglass window that 
could be attached to the litter, enclosing the patient’s upper body. 
Next, both the lid and the litter were covered with aircraft fabric and 
several coats of dope. This laborious process required repeated paint¬ 
ing and drying in the cold, sleet, and snow of the Korean winter. 

The improvised pods and litters proved far from ideal. Loading and 
unloading the patient was an awkward process, since he had to be taken 
from the standard Army field litter, lifted onto a blanket, and then placed 


16 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


into the Stokes litter. Some patients with certain types of casts, splints, 
and dressings could not be moved by helicopter at all because of the con¬ 
fined space of the Stokes litter. The pilots and mechanics improvised 
heating for the inside of these litters by fabricating manifold shrouds and 
ducting warm air off the manifolds into the litters. Even so, the patients 
had to be covered with mountain sleeping bags or plastic bags. If the 
manifold heat were used on one litter only, excess warm air escaped near 
the hose connection; but if heat were turned on both litters, there was not 
enough for either. The problem partly stemmed from the plastic cover; it 
lay directly on the patient and did not allow the heat to circulate properly. 
So the detachments worked with a maintenance company and a Bell Air¬ 
craft technical representative, constructing a three-quarter length cover 
of fabric-covered tubing that could be joined to the original head cover. It 
served as a windbreak and gave space for the heat to circulate over the 
patient’s lower body. 

In July 1951 a new litter mount, manufactured by Bell Aircraft for 
the H-13, reached Korea. These greatly improved mounts accom¬ 
modated a standard Army field litter, eliminating the need to transfer 
a patient to a Stokes litter before placing him in the pod. Unfortunately 
the covers that Bell manufactured for the new mount were usually 
torn up by the slipstream after just thirty days of use. The 
detachments improvised a canvas cover from pup tent shelter halves; 
when used with the zipper and snaps from the Bell cover, it proved far 
superior to the original in that it had a long service life and kept water 
from seeping through onto the patient. The men of the detachments 
used their own money and Korean labor to produce an ample supply 
of covers. 

Even with the improved pods, the external mounting and the 
absence of a medical corpsman on the aircraft produced another dif¬ 
ficulty. Pilots began to notice that many of the casualties needed 
transfusions before being moved to a mobile surgical hospital. In cold 
weather an in-flight transfusion with the fluids stored outside the air¬ 
craft risked deepening the patient’s shock as the fluid temperature 
dropped. At first the pilots would wait the thirty or forty-five minutes 
necessary for a transfusion before departing with a patient. Then Lt. 
Col. James M. Brown, commander of the 8063d Mobile Surgical 
Hospital, devised a method for en route transfusions of plasma or 
whole blood. A bottle of blood or plasma was attached to the inside 
wall of the cockpit within reach of the pilot. Needles and plasma 
would be arranged before departure, and during flight the pilot could 
monitor the fluid flow through the tubes extending to the litter pods. 
A rubber bulb could be used to regulate pressure to the bottle. This 
modification was approved for all medical helicopters in the theater, 
and Bell Aircraft also incorporated it in all its D-model aircraft. 

Since the Eighth Army possessed only thirty-two H-13’s by May 


THE EARLY YEARS 


17 


1951, use ol the valuable craft had to be closely monitored and 
restricted. A recurring problem was that ground commanders 
sometimes requested helicopters more as a convenience than as a 
necessity. To prevent this, the EUSAK Surgeon on 23 June 1951 
disseminated a statement that the role of helicopter evacuation was 
only to provide immediate evacuation of nontransportable and 
critically ill or injured patients who needed surgical or medical care 
not available at forward medical facilities. This statement was given 
wider distribution than had Colonel Dubuy’s in February and it 
noticeably reduced the number of unnecessary missions. 

The detachments offered their service to all of the fighting units in¬ 
volved in the United Nations effort in Korea. At first glance it seemed 
that the language barrier would make many of these missions extremely 
difficult. But the lack of air-ground communications helped in this 
respect, for it precluded any attempt whatsoever at oral communica¬ 
tion between pilots and ground commanders. Most pilots found that 
universal sign language usually sufficed to transmit any information 
necessary to complete an evacuation. In September 1951 one of the 
pilots received a request to pick up two wounded men from a Turkish 
brigade. The pilot recalled: 

When I got to the spot designated I couldn’t find anybody. I was circling around 
when a Turkish observation plane buzzed me. He led me to a wooded area 
on a mountain top where the Turks had dug in. The trees were too high to 
permit a landing. It looked pretty hopeless because I couldn’t communicate 
with them. Finally, I went in close until the rotor blades of the helicopter 
brushed the tops of the trees. The Turks got the pitch. They chopped down 
enough of the trees so that I could land on a ridge. I sat down and the 
Chinese began tossing mortar shells at me. But I got the two wounded Turks 
out. 

Enemy ground resistance to air ambulances in Korea never 
became a severe problem, as it flid later in Vietnam. Few landing 
zones were subject to enemy small arms fire, but many were within 
range of enemy artillery and mortars. Although the pilots generally 
stayed out of landing zones under enemy fire, several had more than 
one encounter with Communist weapons. At one point early in the 
war a company of the 7th Infantry Division was fighting in the area 
known as the Iron Triangle. In assaulting an enemy-held slope, two of its 
soldiers were seriously wounded by the Chinese. A request for an air 
ambulance quickly made its way to the 4th Helicopter Detachment, 
stationed with the 8076th Mobile Surgical Hospital at Chunchon. 
CBS correspondent Robert Pierpoint was there and had received per¬ 
mission to fly with the detachment. Three minutes after the call came 
in, a pilot and Pierpoint flew north toward the pickup site. The men 
on the ground put out colored panels to mark a landing zone on a 


18 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


nearby paddy, while others tried to bring the casualties down from the 
hill. Thirty minutes after the call went out, the helicopter landed at 
the marked position. The pilot and Pierpoint got out. Just as the litter 
bearers made it down the hill, Chinese mortars from across the valley 
opened up on the paddy. A mortar round came in, hit about thirty feet 
from the helicopter tail, and sent the Americans scrambling up the hill. 
The company commander called an artillery battalion 6,000 yards to the 
rear, and had them knock out the Chinese mortar positions. 

The pilots, Pierpoint, and the litter bearers returned to the 
helicopter and loaded the casualties. Not waiting to check for damage, 
the pilot climbed into the smoke-filled cockpit. He could hardly see 
the instruments, but, as soon as Pierpoint jumped in, they made a 
maximum power takeoff. They landed at the hospital at 2120, reading 
their aircraft instruments with a flashlight one of the men at the paddy 
had given them. 

In another respect, Korea was worse than Vietnam: the am¬ 
bulance crews sometimes had to contend with enemy aircraft. 
Although the U.S. Air Force destroyed most of the North Korean air¬ 
craft early in the conflict, the entrance of the Chinese Communists into 
the war in December 1950 brought fast and powerful enemy jet 
fighters to Korea. A few medical helicopters did encounter fire from 
North Korean Yak fighters, but the Americans outmaneuvered the 
faster jets and escaped damage. 

Apart from frontline evacuations, air ambulance detachments 
also flew a few other medical support missions. By the second year of 
the war they routinely transported whole blood to the mobile surgical 
hospitals. This proved valuable because the whole blood tended to 
break down prematurely or clot when carried by surface vehicles over 
the rough Korean roads. The faster means of transport also allowed 
blood storage and refrigeration to be centralized rather than dispersed 
close to the front. The helicopters backhauled some critical patients 
from the mobile surgical hospitals to airstrips for further evacuation to 
one of the general hospitals in Japan. Sometimes they even backhauled 
patients to hospital ships along the coast, such as the Navy’s hospital 
ship Consolation and the Danish Jutlandia^ which were equipped for 
helicopter landings. Since fixed-wing cargo planes flew all casualties 
bound for Japan, the hospital ships remained anchored as floating 
hospitals off Korea rather than act as ferries. 

Most detachment pilots also tried to make the life of the frontline 
soldiers as tolerable as they could. Besides medical supplies and am¬ 
munition, the pilots often took beer, ice cream, and sodas to the front. 
The sight of the helicopter coming in for a landing in the blistering 
Korean summer with the pilot wearing only his boots, a red baseball cap, 
and swimming trunks, and then unloading these otherwise unobtainable 
luxuries, did much to boost the morale of the combat soldiers. 


THE EARLY YEARS 


19 


Apart from yielding a great deal of practical experience, the 
Korean War furthered aeromedical evacuation by convincing the Army 
that the helicopter ambulances deserved a permanent organization. 
When the war broke out, the Army Medical Service commanded neither 
helicopters nor pilots, and its leaders were not committed to further¬ 
ing aeromedical evacuation. In Korea the Eighth Army soon acquired 
virtually complete operational control of the helicopter detachments 
charged with a mission of medical evacuation. But the Surgeon 
General wanted to have the detachments made organic to the Medical 
Service, to have an organization within the Office of the Surgeon 
General capable of directing and administering the aviation 
resources, and to have medical personnel rather than aviators from 
other branches of the Army piloting the aircraft. 

The Surgeon General achieved his first goal with the publication 
on 20 August 1952 of TO&E 8-500A, which provided for an air am¬ 
bulance detachment of seven officers, twenty-one enlisted men, and 
five utility helicopters. The first such unit was the 53d Medical 
Detachment (Helicopter Ambulance), activated at Brooke Army 
Medical Center, Fort Sam Houston, San Antonio, Texas, on 15 
October 1952. In Korea, meanwhile, the ambulance units were 
transfered from the administrative command of the Eighth Army 
Flight Detachment to that of the Eighth Army Surgeon. 

By the end of the war the Surgeon General also succeeded in 
achieving his second goal of creating a special aviation section in his 
office. On 30 June 1952 the Chief of Staff of the Army directed the 
Chairman of the Materiel Review Board to evaluate the Army 
helicopter program. In accordance with the Board’s recommendation, 
the Chief of Staff on 17 October 1952 directed the assistant chiefs of 
staff and the various Army branch chiefs to set up their own agencies 
to supervise and coordinate aviation within each office. The Surgeon 
General’s Office was charged with coordination of all planning, 
operations, personnel staffing, and supply of Army aviation used in 
the Medical Service. On 6 November the office established the Army 
Aviation Section within the Hospitalization and Operations Branch, 
Medical Plans and Operations Division. On the advice of the new 
section, the Surgeon General recommended that “...all aircraft 
designed, developed, or accepted for the Army (regardless of its in¬ 
tended primary use) be chosen with a view toward potential use as air 
ambulances to accommodate a maximum number of standard litters.” 
This advice was followed in 1955 when the Army held a design com¬ 
petition for a new multipurpose utility helicopter. The winner of the 
competition, the Bell Aircraft Corporation’s prototype of the UH-1 
Iroquois (“Huey”), eventually became the Army’s standard am¬ 
bulance helicopter in the Vietnam War. 

During the Korean War the Surgeon General also tried to place 


20 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


Medical Service Corps (MSC) pilots in the cockpits of the Army’s air 
ambulances.^ But he did not succeed until shortly after the armistice 
in 1953. From early 1951 on, the Surgeon General had advocated 
training some MSC officers as aviators, and in the spring of 1952 the 
regulations governing Army aviation were amended to allow MSC 
personnel to become pilots. A quota of twenty-five MSC officers, 
mostly second lieutenants, was set for flight training in October. 
None of the current MSC officers had ever been helicopter pilots, 
although a few had had some aviation training. By early July, fifty- 
three applications for the slots had been received, but only seventeen 
applicants were qualified. Eight MSC officers began flight training in 
October, and one washed out before graduation. The other seven 
graduated on 28 February 1953. In September the Surgeon General’s 
office requested and received a standing quota of ten MSC officers per 
month for attendance at the Army Aviation School at Fort Sill, 
Oklahoma. By 1 October the Medical Service had twenty-four officer 
pilots and soon received five more by transfer from other branches. 
None had flown in Korea before the armistice in July. 

After the Korean War the Surgeon General’s Office applied itself 
to assessing the potential of helicopter ambulances in future conflicts. 
In particular, Lt. Col. Spurgeon H. Neel, Jr., in a number of medical 
and aviation journals, publicized and promoted the Army’s air am¬ 
bulances. The Korean experience, he realized, could not serve as an 
infallible guide to the use of helicopters in other types of wars and dif¬ 
ferent geographical regions, but it certainly showed that helicopters 
had made possible at least a modification of the first links in Letter- 
man’s chain of evacuation. A superior communications system would 
allow a well-equipped and well-staffed ambulance to land at or near 
the site of the wounding, making much ground evacuation un¬ 
necessary. If the patient’s condition could be stabilized briefly, it 
might prove helpful to use the speed of the helicopter to evacuate the pa¬ 
tient farther to the rear, to more complete medical facilities than those 
provided at a rudimentary division clearing station. Triage might be car¬ 
ried out better at a hospital than in the field. But the Korean War and 
the concurrent French struggle in Indochina had afforded only 
limited, imperfect tests of helicopter medical evacuation. The poten¬ 
tial was obvious, but not fully proven. 


^At this time the Army Medical Service consisted ofsix corps: Medical, Dental, Veterinary, 
Army Nurse, Women’s Medical Specialists, and the Medical Service Corps, which provided a 
variety of administrative and technical services. 


CHAPTER II 


Birth Of A Tradition 

The lay of the land and the guerrilla nature of Viet Cong warfare 
in South Vietnam demanded that the American forces stationed there 
from the early 1960s through March 1973 again use the medical 
helicopter. In a country of mountains, jungles, and marshy plains, with 
few passable roads and serviceable railroads, the allied forces waged a 
frontless war against a seldom seen enemy. Even more than in Korea, 
helicopter evacuation proved to be both valuable and dangerous. 

South Vietnam consists of three major geographic features. A 
coastal plain, varying in width from fifteen to forty kilometers, extends 
along most of the 1,400 kilometers of the coast. This plain abuts the 
second feature—the southeastern edge of the Annamite Mountain 
Chain, known in South Vietnam as the Central Highlands, which run 
from the northern border along the old Demilitarized Zone south to 
within eighty kilometers of Saigon. The Central Highlands are mostly 
steep-sloped, sharp-crested mountains varying in height from 5,000 
to 8,000 feet, covered with tangled jungles and broken by many nar¬ 
row passes. The southern third of the country consists almost entirely 
of an arable delta. 

These three geographical features helped shape the four military 
zones of South Vietnam. The northern zone, or I Corps Zone, which 
ran from the Demilitarized Zone down to Kontum and Binh Dinh 
provinces, consisted almost entirely of high mountains and dense 
jungles. At several points the Annamites cut the narrow coastal plain 
and extend to the South China Sea. II Corps Zone ran from I Corps 
Zone south to the southern foothills of the Central Highlands, about 
one hundred kilometers north of Saigon. It consisted of a long stretch of 
the coastal plain, the highest portion of the Central Highlands, and 
the Kontum and Darlac Plateaus. Ill Corps Zone ran from II Corps 
Zone southwest to a line forty kilometers below the capital, Saigon. 
This was an intermediate geographic region, containing the southern 
foothills of the Central Highlands; a few large, dry plains; some thick, 
triple-canopy jungle along the Cambodian border; and the northern 
stretches of the delta formed by the Mekong River to the south. IV 
Corps Zone consisted almost entirely of this delta, which has no forests 
except for dense mangrove swamps at the southernmost tip and 
forested areas just north and southeast of Saigon. Seldom more than 


22 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


twenty feet above sea level, the delta is covered with rice fields 
separated by earthen dikes. During the rainy season the paddies are 
marshy, making helicopter landings and vehicular troop transport ex¬ 
tremely difficult. Hamlets straddle the rivers and canals, and larger 
villages (up to 10,000 people) and cities lie at the junctions of the 
waterways. Bamboo brakes and tropical trees grow around the 
villages and usually extend from 50 to 300 meters back on either side 
of the canal or hamlet. 

The entire country lies below the Tropic of Cancer, between the 
8th and 17th parallels. The climate is generally hot and humid the 
year round. In winter the country lies under a high pressure system 
that causes a dry season in the south. In the summer, however, rains 
fall heavily, varying from torrential downpours to steady mists. The 
northern region of South Vietnam has the most rain, averaging 128 
inches, while the Saigon region averages 80 inches. In the northern 
region and the Central Highlands, where most of the fighting by U.S. 
troops during the war occurred, dense fog and low clouds often 
grounded all aircraft. About ten times a year, usually between July 
and November, typhoons blow in from the South China Sea, soaking 
South Vietnam with heavy rains and lashing it with fierce winds. 

Although the climate and terrain exacerbated the technical problems 
of medical evacuation by helicopter in South Vietnam, the air am¬ 
bulance pilots who worked there worried as much or more about the 
dangers that stemmed from the enemy’s frequent use of guerrilla tactics. 
The Viet Cong were wily, elusive, and intensely motivated. They 
usually had no respect for the red crosses on the doors of the air am¬ 
bulance helicopters. Likely to be annihilated in a large-scale, head-on 
clash with the immense firepower of American troops, they usually 
struck only in raids and ambushes of American and South Viet¬ 
namese patrols. To perform their missions the air ambulance pilots 
often had to fly into areas subject to intense enemy small arms fire. 
Later in the war the pilots encountered more formidable obstacles, 
such as Russian- and Chinese-made ground-to-air missiles. No air 
ambulance pilot could depend on a ground commander’s assurance 
that a pickup zone was secure. Mortar and small arms fire often 
found a zone just as the helicopter touched down. Enemy soldiers 
were known to patiently hide for hours around an ambushed patrol, 
looking for the inevitable rescue helicopter. 

In these conditions the modern techniques of aeromedical evacua¬ 
tion developed and matured. The obstacles of mountain, jungle, and 
floodplain could be overcome only by helicopters. The frontless 
nature of the war also made necessary the helicopter for medical 
evacuation. Air ambulance units found ever wider employment as the 
helicopter —used both as a fighting machine and as a transport 
vehicle —came to dominate many phases of the war. 


BIRTH OF A TRADITION 


23 


The Struggle Begins 

In 1961 President John F. Kennedy took the first of a number of 
measures that over the next four years drew the United States deep 
into the stormy politics of Southeast Asia. In May, Kennedy publicly 
repeated a pledge, first made by President Dwight D. Eisenhower in 
1954, of U.S. support for the government of the Republic of Vietnam. 
Kennedy had the Department of State adopt a less demanding 
diplomacy in its dealings with the troubled regime of President Ngo 
Dinh Diem. The department tried to coax Diem into making urgently 
needed political, economic, and military reforms, but he dallied, and 
the Viet Cong summer campaign of 1961 further weakened his 
tenuous hold on the country. U.S. officials knew that he was losing 
control rapidly when, in September, the rebels captured a provincial 
capital only ninety kilometers from Saigon. 

President Kennedy now believed that he had to decide whether to 
watch a U.S. ally collapse or to find some way of helping Diem fight the 
Viet Cong. In October 1961 Gen. Maxwell D. Taylor, the President’s 
personal military adviser, and Dr. Walt W. Rostow, one of the Presi¬ 
dent’s aides, recommended that the United States commit some of its 
combat troops to Diem’s defense. But Kennedy turned down this pro¬ 
posal. Instead he persuaded Diem to agree to a program of broad 
reforms, in return for the deployment of more U.S. military advisers 
and military equipment to support the combat operations of the Army 
of the Republic of Vietnam (ARVN). 

On 11 December 1961 Saigon saw the arrival of the first direct 
U.S. military support for South Vietnam —the 8th Transportation 
Company from Fort Bragg, North Carolina, and the 57th Transpor¬ 
tation Company from Fort Lewis, Washington. Both were light 
helicopter units. The two companies consisted of 400 pilots, crews, 
and technicians, with thirty-three U.S. Army H-21 Shawnee 
helicopters. The aircraft carrier that brought them, the U.S.S. Core, 
also brought four T-28 single-engine, propeller aircraft en route to 
the Vietnamese National Air Force (VNAF). With its deck towering 
over hundreds of nearby junks, the Core edged up the Saigon River to 
a pier in front of the Majestic Hotel. Thousands of Vietnamese lined 
the riverbanks and watched the start of a new phase in the war 
dividing their country. 

In January and February 1962 two more helicopter companies, 
the 93d Transportation and the 18th Aviation, arrived in Saigon. The 
city struggled to find room for several thousand personnel from 
helicopter companies. Air Force training groups, engineer 
detachments, the Seventh Fleet, and sundry advisory units. The 
South Vietnamese Army, equipped with American armored personnel 
carriers and backed by the new American helicopters, began to show a 


24 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


more aggressive spirit. Accompanied by U.S. advisers, it attacked 
previously inviolate Viet Cong strongholds, such as War Zone D north 
of Saigon, and the U Minh Forest in the southern Mekong Delta. 

The First Air Ambulance Unit in Vietnam 

Despite their early successes in 1962, both the South Vietnamese 
and their American advisers suffered growing numbers of casualties. 
By the end of the year the medical part of the Vietnam troop list had 
expanded to encompass units able to provide a full range of medical 
services for a planned eight thousand U.S. military personnel. In 
Washington, Maj. Gen. James H. Forsee, Chief of Professional Services 
at Walter Reed, and Col. James T. McGibony, Chief of the Medical 
Plans and Operations Division, assured the Surgeon General that the 
medical units assigned to Vietnam would supply fully integrated 
health care. Forsee and McGibony designated the first Army medical 
units that would go to Vietnam to support the U.S. buildup: the 8th 
Field Hospital; medical detachments for dental, thoracic, orthopedic, 
and neurosurgical care; and the 57 th Medical Detachment 
(Helicopter Ambulance). Arriving in April 1962, the 57th remained 
there throughout the next eleven years of American military involve¬ 
ment in that country. 

This long ordeal began for the air ambulance pilots and crews in 
late February 1962, when Headquarters of the U.S. Second Army 
ordered the 57th, stationed at Fort George Meade, Maryland, for a 
permanent assignment to the U.S. Army, Pacific. A frenzied 
logistical effort began. Since the 57th was not authorized a cook, the 
commander, Capt. John Temperelli, Jr., obtained a six months supply 
of C-rations. Since they had no survival equipment, the unit’s men 
hastily made up their kits from local stores. The typical kit, stored in a 
parachute bag, contained a machete, canned water, C-rations, a lensatic 
compass, extra ammunition, a signaling mirror, and sundry items the 
men thought they might need in a crisis. When they arrived in Vietnam 
in late April, the pilots had five “Hueys,” as their UH-1 helicopters 
were nicknamed. Along with the 8th Field Hospital and the other 
medical detachments, the 57th set itself up in the seaside town of Nha 
Trang, 320 kilometers northeast of overcrowded Saigon. The assign¬ 
ment of U.S. Army medical units to Nha Trang prevented a worsen¬ 
ing of the logistics problem in Saigon, but it placed medical support 
far from most of the U.S. military units in the country. 

On its first mission the 57th evacuated a U.S. Army captain advis¬ 
ing the ARVN forces. An evacuation request came on 12 May from 
Tuy Hoa, sixty-five kilometers up the coast from Nha Trang. The 
captain, suffering from an extremely high fever, was carried to the 8th 


BIRTH OF A TRADITION 


25 


Field Hospital. Soon after, the 57th began to evacuate ARVN 
soldiers as well, even from combat. Although the U.S. Military 
Assistance Advisory Group (MAAG) prohibited the 57th from 
evacuating Vietnamese soldiers and civilians. Captain Temperelli 
found this policy to be unrealistic. He had to work closely with local 
Vietnamese officials to set up designated evacuation sites in secure 
areas and to improve the communication nets that relayed the 57th’s 
evacuation requests. Forced to use the ARVN radio channels, the 
57th was obliged to honor requests for evacuation of Vietnamese 
casualties. In the years ahead the air ambulances carried the wounded 
of all nationalities, even those of the enemy. 

As yet, however, the 57th was a new unit, little known, and with 
little to do. It spent most of that summer sitting in Nha Trang, unable 
to get to the fighting. By the end of June the detachment had 
evacuated only twelve American and fourteen ARVN personnel. In 
an attempt to increase his range of action, Temperelli assigned two of 
his Hueys to Qui Nhon, another coastal town some 160 kilometers to 
the north. Neither base had refueling sites in its area. The radius of 
action from each was only 140 kilometers, and most of the fighting 
was at least 200 kilometers to the south. Hoping to add an extra fifty- 
five minutes flying time to each helicopter, Temperelli asked for per¬ 
mission to replace the unnecessary cockpit heaters with auxiliary fuel 
cells; but he never received approval for the change. He also tried to 
have the helicopters’JP-4 fuel stored in certain critical inland areas, 
but was only partially successful. He could also obtain no favorable 
response to his several requests for permission to move the unit to 
Saigon or the Delta. 

Early in July 1962 all commanders of U.S. Army aviation units in 
South Vietnam met in Saigon to discuss the possibility of the exten¬ 
sive use of Army aviation in support of South Vietnamese counterin¬ 
surgency operations. Briefing officers told the commanders that 
greater American military involvement would probably require Army 
aviation to assume many duties formerly assigned to armor, ground 
transport, and the infantry. Captain Temperelli left this conference 
angered that, in spite of the predicted growth of Army aviation in 
Vietnam, the Army Medical Service had so far furnished only limited 
resources to his unit. The reluctance of the Vietnamese Air Force to 
respond to many evacuation requests convinced him that the burden 
of medical evacuation in this war would have to fall on U.S. Army 
helicopter ambulance units. Yet so far the Surgeon General had sent 
no representative to the 57th to see what its problems were. 

In fact, the logistics problems of the 57th were only a small part of 
the shortages that hindered all Army aviation units in the first years of 
the war. Deficiencies and excesses in the authorized lists of equipment 


26 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


too often appeared only after units were committed to combat. Many 
of the aviation units carried unnecessary heaters and winter clothing 
with them to Vietnam simply because the standard equipment list 
called for them. Red tape compounded equipment problems. At first 
the aviation units sent their orders for parts directly to the U.S. Army 
on Okinawa, but Okinawa often returned the paperwork for correc¬ 
tions to comply with directives that the forces in Vietnam had never 
heard of. Only after several months of logistical chaos did the Army 
Support Group, Vietnam (USASGV) begin to coordinate the requisi¬ 
tion of parts. 

In this first year of operations Army supply depots in the Pacific 
could fill only three-fourths of the aviation orders from Vietnam. This 
problem arose partly from the unusual role of the Army aviation units 
there. Army helicopters used in support of ARVN operations flew far 
more hours and wore out much faster than peacetime supply 
estimates provided for. By November 1962 the Army had thirteen 
aviation units flying 199 aircraft of eight types at ten places in Viet¬ 
nam. Multiple bases for several units added to the units’ supply 
needs. 

Since the 57th Medical Detachment had the only UH-l’s in Viet¬ 
nam so far, it could draw on no pool of replacement parts. Instead, it 
had to cannibalize one of its own helicopters to keep the others flying. 
When Gen. Paul D. Harkins, commander of the Military Assistance 
Command, Vietnam (MACV), and Gen. Earle G. Wheeler, Army 
Chief of Staff, visited Nha Trang in August 1962, they saw two of the 
57th’s UH-l’s sitting on a ramp, with no rotor blades. The 57th had 
no spares. 

Then combat aviation units began to demand the 57th’s few re¬ 
maining parts. In November, feeling confident after an influx of new 
infantry equipment from the United States, the South Vietnamese 
Army planned a large scale combat assault into the “Iron Triangle,” a 
Viet Cong stronghold northwest of Saigon. Armed Huey UH-l’s 
were to cover the CH-21’s carrying ARVN troops to the landing 
zones. Since several of the Hueys had bad tail rotor gear boxes and 
faulty starter generators, the 57th received instructions to bring all its 
starter generators to Saigon. Plainly, the unit’s craft were about to be 
cannibalized. 

To head off the danger, Temperelli accompanied the generators to 
Saigon and reported to Brig. Gen. Joseph W. Stilwell, commander of 
the Army Support Group, Vietnam. Noting that the absence of the 
generators on the 57th’s aircraft would leave South Vietnam without 
air evacuation coverage, Temperelli suggested that the 57th might fly 
down to support the ARVN assault. But Stilwell said no. Temperelli 
handed over the generators and left, taking with him a promise that 
they would be returned after the operation. Only one ever made it 


BIRTH OF A TRADITION 


27 


back, and the 57th was totally grounded from 17 November to 15 
December. When he recovered the one generator, Temperelli shifted 
the 57th’s one flying aircraft back and forth between Nha Trang and 
Qui Nhon to provide some coverage at each location. 

A graver danger to the 57th’s independence developed out of its 
medical mission. For most of the Korean War, Army ambulance 
helicopters had served under the aegis of the Army Medical Service, 
attached to the hospitals behind the corps areas. But in September 
1962 General Stilwell considered ending this policy in Vietnam by 
transferring the 57th from the Medical Service to the Army Transpor¬ 
tation Corps, which then controlled all other Army helicopters in 
Vietnam. Temperelli, accompanied by Lt. Col. Carl A. Fischer, 
USASGV Surgeon and commander of the 8th Field Hospital, again 
went to Saigon. This time he was more successful, convincing Stilwell 
to maintain the old policy. 

Temperelli also deflected other attacks on the 57th’s integrity. 
Because of the relatively few hours flown by the pilots in their first 
year in Vietnam, other Army aviators there argued against dedicating 
any helicopters to medical evacuation. Some suggested removing the 
red crosses from medical helicopters and assigning general support 
tasks to any idle medical aircraft. In another attempt to coopt the 
57th’s resources, the senior MAAG advisor in Qui Nhon tried several 
times to commandeer a standby evacuation ship; but each time the 
57 th told him that he could have priority on the craft only if he were a 
casualty. All in all, 1962 was not a good year for the air ambulance 
unit and its pilots. 

Early in January 1963, however, an ARVN assault in the Delta 
convinced many skeptics that the 57th ought to be brought closer to 
the scene of battle. South Vietnamese intelligence had heard of an 
enemy radio station operating near the village of Ap Bac in the Plain 
of Reeds. Fifty U.S. advisers and 400 men of the ARVN 7th Infantry 
Division flew ten CH-21 Shawnee helicopters to the area. Five armed 
UH“l’s that would serve as close air cover escorted the convoy. 

The first three waves of helicopters dropped their troops into the 
landing zone without difficulty. But just as the fourth wave was 
touching down, Viet Cong opened fire with automatic weapons and 
shot down four of the CH-21’s. A U.S. Army UH-IB moved into the 
face of the enemy fire to try to rescue one of the downed crews. It too 
crashed —the first UH-IB destroyed by the enemy in the Vietnam 
War. The other four UH-l’s suppressed the Viet Cong fire, allowing 
the remaining Shawnees to leave the hotly contested area without fur¬ 
ther loss. 

Other than for the unusually large number of forces involved, the 
battle was typical for this period: in the ground fight that followed, the 
South Vietnamese infantry failed to surround the Viet Cong, who 


396-454 0-82 


3 


28 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


escaped under cover of night. Three American advisers and sixty-five 
ARVN soldiers were killed. The 57th Medical Detachment, still sta¬ 
tioned at Nha Trang and Qui Nhon, far to the north, could not help 
evacuate the wounded. 

The losses suffered at Ap Bac impressed on Army commanders 
that the air ambulances might be best employed near the fighting. On 
16 January the Support Group ordered the 57th to move to Saigon. 
By this time the 57th had only one flyable aircraft, at Qui Nhon. But 
Support Group told Gaptain Temperelli that new UH-lB’s were on 
the way. On 30 January the 57th arrived at Tan Son Nhut Air Base in 
Saigon. 


Dust Off Takes Form 

The pilots and crews found Saigon much different from Qui Nhon 
and Nha Trang. Here they enjoyed access to a large, fully stocked 
post exchange and commissary. Local Vietnamese stores sold French 
wines, liqueurs, and champagnes, and the post exchange sold popular 
American spirits. The Armed Forces Radio Station broadcast the 
latest American music and reported ball game scores. The officers 
had clubs in the Brink and Rex Hotels, and the Five Oceans Club in 
the Cholon Officers’ Open Mess. The French-sponsored Cercle Spor- 
tif provided the officers swimming and tennis, and the Club Nautique 
offered water-skiing, rowing, and motorboating. Also available were 
the Saigon Tennis Club, the Saigon Golf Club, and the Cercle Hip- 
pique for horseback riding. The city even boasted a six-lane bowling 
alley. Some of the pilots frequented cafes like the Riverboat 
Restaurant, and one even sang for a while in a downtown nightclub. 

The veterans had little time to enjoy such amenities. In late 
February 1963 Captain Temperelli passed the reins of the 57th to a 
new commander, Maj. Lloyd E. Spencer. The veteran pilots rotated 
out of Vietnam and their replacements arrived. Shortly after Spencer 
arrived in Saigon, General Stilwell called him in for an interview. 
Slapping at a map of South Vietnam, Stilwell asked Spencer how he 
proposed to cover all the country with only five aircraft. All that 
Spencer could say was that the 57th would do its best. After a lengthy 
discussion of problems, Stilwell again promised the 57th the first five 
new UH-lB’s in South Vietnam. On 11 March the unit signed over 
the last of its grounded UH-lA’s for return to the States. The next 
day Support Group issued the detachment five new UH-lB’s that 
were still on a ship in the Saigon Harbor. On 23 March the 57th 
declared itself fully operational again. 

But Saigon brought its own problems. The 57th’s assigned park¬ 
ing area at Tan Son Nhut Airport was directly behind the area where 
the Vietnamese Air Force pilots parked their C-47 Dakotas. When 


BIRTH OF A TRADITION 


29 


the VNAF pilots started their planes, always parked with the tails 
towards the 57th’s area, the engines spattered oil all over the bubbles, 
windows, and windshields of the Hueys. Several times the 57th’s 
crews asked the Vietnamese to park the C-"47’s facing another direc¬ 
tion, but the pilots refused. The 57th’s solution to the problem, while 
it did not foster allied harmony, was effective. Spencer explained: 
“When you fly a helicopter over the tail of a C-47 it really plays hell 
with the plane’s rear elevators; so the Vietnamese got the message and 
moved the C-47’s.” 

In April, part of the 57th’s pilots and crews bade farewell to the 
comforts of Saigon when two of the aircraft went on a semipermanent 
standby to the town of Pleiku, some 120 kilometers northwest of the 
57th’s old base at Qui Nhon. Pleiku lies in Vietnam’s Annamite 
mountain chain. That month a 57th helicopter at Pleiku joined a 
search and rescue mission for a B-26 that had crashed while covering 
a combat assault. The crew found the B-26 lying on a pinnacle, but 
could not land because of the stunted trees and other growth that 
covered the peak. While the pilot hovered as low as possible, the crew 
chief and the medical corpsman leaped from the Huey to the ground, 
where they cut out a landing area. The Huey landed and the men 
removed the B-26’s .50-caliber machine guns and the bodies of its 
three Air Force crewmen. 

The 57th’s two units in the north stood duty round the clock, until 
their operational commanders canceled night missions after a 
transport aircraft went down on a flight in darkness over the South 
China Sea. Most of their missions were to small U.S. Army Special 
Forces teams scattered among the Montagnard villages in the wild 
highlands. The Viet Cong there had none of the sophisticated 
weapons used by their compatriots in the south. The air ambulances 
at Pleiku contended with only homemade guns, crossbows, and a few 
firearms the Viet Cong had captured from ARVN troops. 

In late June, one of the Hueys at Pleiku moved to Qui Nhon to 
resume coverage of that sector. In I Corps Zone to the north, U.S. 
Marine H-34 helicopters furnished both combat aviation support and 
medical evacuation. The 57th’s aircraft at Pleiku and Qui Nhon 
covered II Corps Zone, and the three in Saigon covered III and IV 
Corps Zones. Although all the four corps regions of South Vietnam 
had some form of medical evacuation, it was thinly spread. 

For the past year the 57th had worked without a tactical call sign, 
simply using “Army” and the tail number of the aircraft. For example, 
if a pilot were flying a helicopter with the serial number 62-12345, his 
call sign would be “Army 12345.” The 57th communicated internally 
on any vacant frequency it could find. Major Spencer decided that 
this slapdash system had to go. In Saigon he visited Navy Support Ac¬ 
tivity, which controlled all the call words in South Vietnam. He 


30 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


received a Signal Operations Instructions book that listed all the 
unused call words. Most, like “Bandit,” were more suitable for assault 
units than for medical evacuation units. But one entry, “Dust Off,” 
epitomized the 57th’s medical evacuation missions. Since the coun¬ 
tryside then was dry and dusty, helicopter pickups in the fields often 
blew dust, dirt, blankets, and shelter halves all over the men on the 
ground. By adopting “Dust Off,” Spencer found for Army 
aeromedical evacuation in Vietnam a name that lasted the rest of the 
war. 

Even though distinguished by its own name, the 57th still had no 
formal mission statement. Its pilots worked on the assumption that 
their main purpose was to evacuate wounded and injured U.S. 
civilians and military personnel. It continued to provide this service to 
the Vietnamese as well when resources permitted. Like Captain 
Temperelli, Major Spencer also felt pressure to allow ground com¬ 
manders to use Dust Off aircraft for routine administrative flights, 
but with General Stilwell’s support he kept the 57th focused on its 
medical mission. If the 57th had already scheduled one of its aircraft 
for a routine flight, it sometimes accepted healthy passengers on a 
space-available basis, with the proviso that the passengers might have 
to leave the ship in the middle of nowhere if the pilot received a Dust 
Off request while in the air. 

As the year went on, the 57th flew Dust Off missions more often. 
On one day alone, 10 September 1963, it evacuated 197 Vietnamese 
from the Delta, where large Viet Cong forces had virtually destroyed 
three settlements. That day Dust Off helicopters made flights with 
Vietnamese jammed into the passenger compartment and standing 
on the skids. The last flight out took place at night, and the three air¬ 
craft flew near a firefight on the ground. After a few tracer rounds 
arced up toward their helicopters, the pilots blacked out their ships 
and flew on to Saigon. 

The first nine months of the year had brought important changes. 
Dust Off had a name, solid support from above, a mission —though 
no mission statement —and a great deal more business. Its problems 
reflected its new-found popularity. 

Relations with the South Vietnamese 

Although the number of Vietnamese casualties rose in 1963, the 
South Vietnamese military refused to set up its own aeromedical 
evacuation unit. The VNAF response to requests for medical evacua¬ 
tion depended on aircraft availability, the security of the landing 
zone, and the mood and temperament of the VNAF pilots. If the 
. South Vietnamese had no on-duty or standby aircraft ready to fly a 
medical evacuation mission they passed the request on to the 57th. 


BIRTH OF A TRADITION 


31 


Even when they accepted the mission themselves, their response 
usually suffered from a lack of leadership and poor organization. 
Since South Vietnamese air mission commanders rarely flew with 
their flights, the persons responsible for deciding whether to abort a 
mission often lacked the requisite experience. As a MACV summary 
said: “Usually the decision was made to abort, and the air mission 
commander could do nothing about it. When an aggressive pilot was 
in the lead ship, the aircraft came through despite the firing. 
American advisers reported that on two occasions only the first one or 
two helicopters landed; the rest hovered out of reach of the wounded 
who needed to get aboard.” 

An example of the poor quality of VNAF medical evacuation oc¬ 
curred in late October 1963, when the ARVN 2d Battalion, 14th 
Regiment, conducted Operation Long Huu II near O Lac in the 
Delta. At dawn the battalion began its advance. Shortly after they 
moved out, the Viet Cong ambushed them, opening fire from three 
sides with automatic weapons and 81-mm. mortars. At 0700 casualty 
reports started coming into the battalion command post. The bat¬ 
talion commander sent his first casualty report to the regimental 
headquarters at 0800: one ARVN soldier dead and twelve wounded, 
with more casualties in the paddies. He then requested medical 
evacuation helicopters. By 0845 the casualty count had risen to seven¬ 
teen lightly wounded, fourteen seriously wounded, and four dead. He 
sent out another urgent call for helicopters. The battalion executive 
officer and the American adviser prepared two landing zones, one 
marked by green smoke for the seriously wounded and a second by 
yellow smoke for the less seriously wounded. Not until 1215 did three 
VNAF H-34’s arrive over O Lac to carry out the wounded and dead. 
During the delay the ARVN battalion stayed in place to protect their 
casualties rather than pursue the retreating enemy. The American 
adviser wrote later: “It is common that, when casualties are sustained, 
the advance halts while awaiting evacuation. Either the reaction time 
for helicopter evacuation must be improved, or some plan must be 
made for troops in the battalion rear to provide security for the 
evacuation and care of casualties.” 

The ARVN medical services also proved inadequate to handle the 
large numbers of casualties. In the Delta, ARVN patients were usual¬ 
ly taken to the Vietnamese Provincial Hospital at Can Tho. As the 
main treatment center for the Delta, it often had a backlog of patients. 
At night only one doctor was on duty, for the ARVN medical service 
lacked physicians. If Dust Off flew in a large number of casualties, 
that doctor normally treated as many as he could; but he rarely called 
in any of his fellow doctors to help. In return they would not call him 
on his night off Many times at night Dust Off pilots would have to 
make several flights into Can Tho. On return flights the pilots often 


32 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


found loads of injured ARVN soldiers lying on the landing pad where 
they had been left some hours earlier. After several such flights few 
pilots could sustain any enthusiasm for night missions. 

Another problem was that the ARVN officers sometimes bowed to 
the sentiments of their soldiers, many of whom believed that the soul 
lingers between this world and the next if the body is not properly 
buried. They insisted that Dust Off ships fly out dead bodies, 
especially if there were no seriously wounded waiting for treatment. 
Once, after landing at a pickup site north of Saigon, a Dust Off crew 
saw many ARVN wounded lying on the ground. But the other 
ARVN soldiers brought bodies to the helicopter to be evacuated first. 
As the soldiers loaded the dead in one side of the ship, a Dust Off 
medical corpsman pulled the bodies out the other side. The pilot 
stepped out of the helicopter to explain in halting French to the 
ARVN commander that his orders were to carry out only the wound¬ 
ed. But an ARVN soldier manning a .50-caliber machine gun on a 
nearby armored personnel carrier suddenly pointed his weapon at the 
Huey. This convinced the Dust Off crew to fly out the bodies. They 
carried out one load but did not return for another. 

Kelly and the Dust Off Mystique 

Early in 1964 the growing burden of aeromedical evacuation fell 
on the 57th’s third group of new pilots, crews, and maintenance per¬ 
sonnel. The helicopters were still the 1963 UH-IB models, but most 
of the new pilots were fresh from flight school. The new commander, 
Maj. Charles L. Kelly, from Georgia, was a gruff, stubborn, 
dedicated soldier who let few obstacles prevent him from finishing a 
task. Within six months he set an example of courage and hard work 
that Dust Off pilots emulated for the rest of the war. 

Kelly quickly took advantage of the 57th’s belated move to the 
fighting in the south. On 1 March 1964 Support Group ordered the 
aircraft at Pleiku and Qui Nhon to move to the Delta. Two helicopters 
and five pilots, now called Detachment A, 57th Medical Detachment 
(Helicopter Ambulance), Provisional, flew to the U.S. base at Soc 
Trang. Once a fighter base for both the French and the Japanese, Soc 
Trang was a compound roughly 1,000 by 3,000 feet, surrounded by 
rice paddies. 

Unit statistics soon proved the wisdom of the move south: the 
number of evacuees climbed from 193 in February to 416 in March. 
Detachment A continued its coverage of combat in the Delta until Oc¬ 
tober 1964, when another helicopter ambulance detachment from the 
States took over that area. Major Kelly, who had taken command of 
the 57th on 11 January, moved south with Detachment A, preferring 
the field and flying to ground duty in Saigon. 


BIRTH OF A TRADITION 


33 


Detachment A in Soc Trang lived in crude “Southeast Asia” huts 
with sandbags and bunkers for protection against enemy mortar and 
ground attack. The rest of the 57th in Saigon struggled along with air 
conditioning, private baths, a mess hall, and a bar in their living 
quarters. In spite of the contrast, most pilots preferred Soc Trang. It 
was there that Major Kelly and his pilots forged the Dust Off tradition 
of valorous and dedicated service. 

Major Kelly and his teams also benefited from two years of grow¬ 
ing American involvement in Vietnam. By the spring of 1964 the 
United States had 16,000 military personnel in South Vietnam (3,700 
officers and 12,300 enlisted men). The Army, which accounted for 
10,100 of these, had increased its aircraft in South Vietnam from 40 
in December 1961 to 370 in December 1963. For the first time since 
its arrival two years ago the 57th was receiving enough Dust Off re¬ 
quests to keep all its pilots busy. 

But Major Kelly faced one big problem when he arrived: the 
helicopters that the 57th had received the year before were showing 
signs of age and use, and General Stilwell, the Support Group com¬ 
mander, could find no new aircraft for the detachment. Average flight 
time on the old UH-lB’s was 800 hours. But this did not deter the 
new pilots from each flying more than 100 hours a month in medical 
evacuations. Some of them stopped logging their flight time at 140 
hours, so that the flight surgeon would not ground them for exceeding 
the monthly ceiling. 

The new team continued and even stepped up night operations. 
In April 1963 the detachment flew 110 hours at night while evacuating 
ninety-nine patients. To aid their night missions in the Delta the pilots 
made a few special plotting flights, during which they sketched charts 
of the possible landing zones, outlined any readily identifiable terrain 
features, and noted whether radio navigational aid could be received. 

During one such flight Major Kelly and his copilot heard on their 
radio that a VNAF T-28, a fixed-wing plane, had gone down. After 
joining the search, Kelly soon located the plane. While he and his 
crew circled the area trying to decide how to approach the landing 
zone, the Viet Cong below opened fire on the helicopter. One round 
passed up through the open cargo door and slammed into the ceiling. 
Unfazed, Kelly shot a landing to the T-28, taking fire from all sides. 
Once down, he, his crew chief, and his medical corpsman jumped out 
and sprayed submachine gun fire at the Viet Cong while helping the 
VNAF pilot destroy his radios and pull the M60 machine guns from 
his plane. Kelly left the area without further damage and returned the 
VNAF pilot to his unit. Kelly and his Dust Off crew flew more than 
500 miles that day. 

On 2 April one of the Detachment A crews flying to Saigon from 
Soc Trang received a radio call that a village northwest of them had 


34 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


been overrun. Flying up to the area where the Mekong River flows 
into South Vietnam from Cambodia, they landed at the village of Cai 
Cai, where during the night Viet Cong had killed or wounded all the 
people. Soldiers lay at their battle stations where they had fallen, 
women and children where they had been shot. The Dust Off teams 
worked the rest of the day flying out the dead and wounded, putting 
two or three children on each litter. 

One night that spring Detachment A pilots Capt. Patrick H. Brady 
and 2d Lt. Ernest J. Sylvester were on duty when a call came in that an 
Al-E Skyraider, a fixed-wing plane, had gone down near the town of 
Rach Gia. Flying west to the site, they radioed the Air Force radar con¬ 
troller, who guided them to the landing zone and warned them of Viet 
Cong antiaircraft guns. As the Dust Off ship drew near the landing 
zone, which was plainly marked by the burning Al-E, the pilot of 
another nearby Al-E radioed that he had already knocked out the 
Viet Cong machine guns. But when Brady and Sylvester approached 
the zone the Viet Cong opened fire. Bullets crashed into the cockpit 
and the pilots lost control of the aircraft. Neither was seriously 
wounded and they managed to regain control and hurry out of the 
area. Viet Cong fire then brought down the second Al-E. A third ar¬ 
rived shortly and finally suppressed the enemy fire, allowing a second 
Dust Off ship from Soc Trang to land in the zone. The crew chief and 
medical corpsman found what they guessed was the dead pilot of the 
downed aircraft, then found the pilot of the second, who had bailed 
out, and flew him back to Soc Trang. 

A short time later Brady accompanied an ARVN combat assault 
mission near Phan Thiet, northeast of Saigon. While Brady’s Dust 
Off ship circled out of range of enemy ground fire, the transport 
helicopters landed and the troops 'moved out into a wooded area 
heavily defended by the Viet Cong. The ARVN soldiers immediately 
suffered several casualties and called for Dust Off. Brady’s aircraft 
took hits going into and leaving the landing zone, but he managed to 
fly out the wounded. In Phan Thiet, while he was assessing the 
damage to his aircraft, an American adviser asked him if he would 
take ammunition back to the embattled ARVN unit when he re¬ 
turned for the next load of wounded. After discussing the propriety of 
carrying ammunition in an aircraft marked with red crosses, Brady 
and his pilots decided to consider the ammunition as “preventive 
medicine” and fly it in to the ARVN troops. Back at the landing zone 
Brady found that Viet Cong fire had downed an L-19 observation 
plane. Brady ran to the crash site but both the American pilot and the 
observer had been killed. The medical corpsman and crew chief 
pulled the bodies from the wreckage and loaded them on the 
helicopter. Brady left the ammunition and flew out with the dead. 

By the time the helicopter had finished its mission and returned to 


BIRTH OF A TRADITION 


35 


Tan Son Nhut, most of the 57th were waiting. News of an American 
death traveled quickly in those early days of the war. Later, reflecting 
on the incident, Kelly praised his pilots for bringing the bodies back 
even though the 57th’s mission statement said nothing about moving 
the dead. But he voiced renewed doubts about the ferrying of am¬ 
munition. 

In fact, the Dust Off mission was again under attack. When Sup¬ 
port Command began to pressure the 57th to place removable red 
crosses on the aircraft and begin accepting general purpose missions, 
Kelly stepped up unit operations. Knowing that removable red 
crosses had already been placed on transport and assault helicopters 
in the north, Kelly told his men that the 57th must prove its worth — 
and by implication the value of dedicated medical helicopters —be¬ 
yond any shadow of doubt. 

Whereas the 57th before had flown missions only in response to a 
request, it now began to seek missions. Kelly himself flew almost 
* every night. As dusk came, he and his crew would depart Soc Trang 
and head southwest for the marshes and Bac Lieu, home of a team 
from the 73d Aviation Company and detachments from two signal 
units, then further south to Ca Mau, an old haunt of the Viet Minh, 
whom the French had never been able to dislodge from its forested 
swamps. Next they would fly south almost to the tip of Ca Mau 
Peninsula, then at Nam Can reverse their course toward the Seven 
Canals area. After a check for casualties there at Vi Thanh, they turn¬ 
ed northwest up to Rach Gia on the Gulf of Siam, then on to the 
Seven Mountains region on the Cambodian border. From there they 
came back to Can Tho, the home of fourteen small American units, 
then up to Vinh Long on the Mekong River, home of the 114th Air¬ 
mobile Company. Next they flew due east to True Giang, south to the 
few American advisers at Phu Vinh, then home to Soc Trang. The 
entire circuit was 720 kilometers. 

If any of the stops had patients to be evacuated, Kelly’s crew load¬ 
ed them on the aircraft and continued on course, unless a patient’s 
condition warranted returning immediately to Soc Trang. After 
delivering the patients, they would sometimes resume the circuit. 
Many nights they carried ten to fifteen patients who otherwise would 
have had to wait until daylight to receive the care they needed. In 
March this flying from outpost to outpost, known as “scarfing,” 
resulted in seventy-four hours of night flying that evacuated nearly 
one-fourth of that month’s 450 evacuees. The strategem worked; 
General Stilwell dropped the idea of having the 57th use removable 
red crosses. 

Although most of Dust Off’s work in the Delta was over flat, 
marshy land. Detachment A sometimes had to work the difficult 
mountainous areas near the Cambodian border. Late on the after- 


36 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


noon of 11 April Kelly received a mission request to evacuate two 
wounded ARVN soldiers from Phnom Kto Mountain of the Seven 
Mountains of An Giang Province. When he arrived he found that the 
only landing zone near the ground troops was a small area sur¬ 
rounded by high trees below some higher ground held by the Viet 
Cong. Despite the updrafts common to mountain flying, the mists, 
and the approaching darkness, Kelly shot an approach to the area. 
The enemy opened fire and kept firing until Kelly’s ship dropped 
below the treetops into the landing zone. Kelly could set the aircraft 
down on only one skid; the slope was too steep. Since only one of the 
wounded was at the landing zone, Kelly and his crew had to balance 
the ship precariously while waiting for the ARVN troops to carry the 
other casualty up the mountain. With both patients finally on board, 
Kelly took off and again flew through enemy fire. The medical corps- 
man promptly began working on the Vietnamese, one of whom had 
been wounded in five places. Both casualties survived. 

When Kelly flew such a mission he rarely let bad weather, 
darkness, or the enemy stop him from completing it. He fought his 
way to the casualties and brought them out. On one mission the 
enemy forced him away from the landing zone before he could place 
the patients on board. An hour later he tried to land exactly the same 
way, through enemy fire, and this time he managed to load the pa¬ 
tients safely. The Viet Cong showed their indifference to the red 
crosses on the aircraft by trying to destroy it with small arms, 
automatic weapons, and mortars, even while the medical corpsman 
and crew chief loaded the patients. One round hit the main fuel drain 
valve and JP-4 fuel started spewing. Kelly elected to fly out anyway, 
practicing what he had preached since he arrived in Vietnam by put¬ 
ting the patients above all else and hurrying them off the battlefield. 
He radioed the Soc Trang tower that his ship was leaking fuel and did 
not have much left, and that he wanted priority on landing. The 
tower operator answered that Kelly had priority and asked whether he 
needed anything else. Kelly said, “Yes, bring me some ice cream.” 
Just after he landed on the runway the engine quit, fuel tanks empty. 
Crash trucks surrounded the helicopter. The base commander drove 
up, walked over to Kelly, and handed him a quart of ice cream. 

Apart from the Viet Cong, the 57th’s greatest problem at that time 
was a lack of pilots. After Kelly reached Vietnam he succeeded in 
having the other nine Medical Service Corps pilots who followed him 
assigned to the 57th. He needed more, but the Surgeon General’s 
Aviation Branch seemed to have little understanding of the rigors of 
Dust Off flying. In the spring of 1964 the Aviation Branch tried to 
have new Medical Service Corps pilots assigned to nonmedical 
helicopter units in Vietnam, assuming that they would benefit more 
from combat training than from Dust Off flying. In late June Kelly 


BIRTH OF A TRADITION 


37 


gave his response: 

As for combat experience, the pilots in this unit are getting as much or more 
combat-support flying experience than any unit over here. You must under¬ 
stand that everybody wants to get into the Aeromedical Evacuation Business. 
To send pilots to U.T.T. [a nonmedical unit] or anywhere else is playing 
right into their hands. I fully realize that I do not know much about the big 
program, but our job is evacuation of casualties from the battlefield. This we 
are doing day and night, without escort aircraft, and with only one ship for 
each mission. The other [nonmedical] units fly in groups, rarely at night, 
and always heavily armed. 

In other words, Kelly thought that his unit had a unique job to do and 
that the only effective training for it could be found in the cockpit of a 
Dust Off helicopter. 

With more and more fighting occurring in the Delta and around 
Saigon, the 57th could not always honor every evacuation request. 
U.S. Army helicopter assault companies were forced to keep some of 
their aircraft on evacuation standby, but without a medical corpsman 
or medical equipment. Because of the shortage of Army aviators and 
the priority of armed combat support, the Medical Service Corps did 
not have enough pilots to staff another Dust Off unit in Vietnam. 
Most Army aeromedical evacuation units elsewhere already worked 
with less than their permitted number of pilots. Although Army avia¬ 
tion in Vietnam had grown considerably since 1961, by the summer 
of 1964 its resources fell short of what it needed to perform its mis¬ 
sions, especially medical evacuation. 

Army commanders, however, seldom have all the men and 
material they can use, and Major Kelly knew that he had to do his 
best with what he had. On the morning of 1 July 1964 Kelly received 
a mission request from an ARVN unit in combat near Vinh Long. 
An American sergeant, the adviser, had been hit in the leg by 
shrapnel from a mortar round. Several of the ARVN infantry were 
also wounded. Kelly and his crew flew to the area. The Viet Cong 
were close in to the ARVN soldiers and the fighting continued as Kel¬ 
ly’s helicopter came in to a hover. Kelly floated his ship back and 
forth, trying to spot the casualties. The Viet Cong opened fire on his 
ship. The ARVN soldiers and their American advisers were staying 
low. One adviser radioed Kelly to get out of the area. He answered, 
“When I have your wounded.” Many rounds hit his aircraft before 
one of them passed through the open side door and pierced his heart. 
He murmured “My God,” and died. His ship pitched up, nosed to the 
right, rolled over, and crashed. 

The rest of the crew, shaken but not seriously injured, crawled 
from the wreck and dragged Kelly’s body behind a mound of dirt. 
Dust Off aircraft later evacuated Kelly’s crew and the other casualties. 

The United States awarded him the Distinguished Service Cross 


38 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


posthumously. South Vietnam conferred the Military Order Medal of 
Vietnam, National Order, Fifth Class, and the Cross of Gallantry 
with Palm. Far more important than the medals he earned was his 
legacy to the hundreds of Dust Off pilots who followed him. His death 
saddened all who had known him, for he had given so much of himself 
so selflessly. The men of the 57th heard that General Stilwell, Kelly’s 
commander for the last six months, wept when he heard of his death. 

Capt. Paul A. Bloomquist took command of the 57th Medical 
Detachment in Saigon and Capt. Patrick H. Brady moved to Soc 
Trang to take over Detachment A. Assuming that the 57th would now 
select its missions more carefully, the commander of the 13th Aviation 
Battalion in the Delta called Brady into his office. He asked what 
changes would be made now that Kelly was gone. Brady told him that 
the 57th would continue flying missions exactly as Kelly had taught 
them, accepting any call for help. 

A New Buildup 

Kelly’s death coincided with an important turning point in U.S. 
relations with North and South Vietnam. In the first half of 1964 the 
new administration of President Lyndon B. Johnson concluded that 
the growing political and military disturbances in South Vietnam re¬ 
quired a commitment of larger U.S. economic and military resources 
in the area. In March 1964, after visiting South Vietnam, Secretary 
of Defense Robert McNamara recommended that the United States 
increase its aid to the Republic of Vietnam. President Johnson im¬ 
mediately increased U.S. aid to South Vietnam by $60 million. He 
also promised to obtain new equipment for the South Vietnamese 
Army, to finance a 50,000-man increase in South Vietnamese forces, 
and to provide funds for the modernization of the country’s govern¬ 
ment. At his request the Joint Chiefs of Staff began to draft plans for 
the retaliatory bombing of North Vietnam. Over the next few months 
the South Vietnamese government of Maj. Gen. Nguyen Khanh was 
unable to make good use of the increased U.S. aid; American advisers 
in the countryside reported that Khanh’s political power was still 
crumbling. General Khanh and Air Commodore Nguyen Cao Ky, 
commander of the South Vietnamese Air Force, began a public cam¬ 
paign to place all blame for the deteriorating conditions on North 
Vietnam and draw the United States even further into the conflict. 

The United States was already more deeply involved than most 
Americans knew. For some time United States forces had taken part 
in clandestine amphibious raids on the North Vietnamese coast to 
gather intelligence. In the spring of 1964 the Johnson administration 
publicly stated that the United States was stockpiling for the possible 
deployment of large numbers of American troops in Southeast Asia. 


BIRTH OF A TRADITION 


39 


The administration also surrounded with great publicity the dedica¬ 
tion of the new U.S.-built airbase at Da Nang, on the northernmost 
part of South Vietnam’s coast. 

These American threats had no effect on the Viet Cong or the 
North Vietnamese, who continued to bring supplies south through 
trails in Laos and to stage daring terrorist raids even in the center of 
Saigon. The North Vietnamese Navy openly challenged the United 
States in early August 1964 when its torpedo patrol boats attacked two 
U.S. destroyers sailing in the Gulf of Tonkin. Congress, outraged by 
this seemingly unprovoked attack in international waters, quickly 
gave President Johnson nearly unanimous approval to take whatever 
measures he thought necessary to protect U.S. forces in the area. 

As U.S. involvement mounted, the requests made by Kelly and 
Stilwell for another air ambulance unit at last took effect. In August 
the Surgeon General’s Office named five more helicopter ambulance 
detachments for assignment to Southeast Asia. The 82d Medical 
Detachment (Helicopter Ambulance) at Fort Sam Houston, Texas, 
was alerted for a 1 October move. The other four detachments were 
put on notice without firm departure dates and told to bring their 
units to full strength. 

The advance party of the 82d arrived in Saigon on 5 October, and 
the next day Support Group, Vietnam, gave the detachment five new 
UH-lB’s. The rest of the detachment arrived two weeks later. The of¬ 
ficers and enlisted men of the 82d spent their first nights in Saigon 
billeted with their counterparts in the 57th. There they heard disturb¬ 
ing war stories from the veterans, then left for their new home in Soc 
Trang. Most of the detachment traveled by convoy, down Route 4 
through the alien Delta countryside. Their first sight of Soc Trang—a 
small airstrip with a tiny village at one end, lying in the middle of rice 
paddies, with only a triple-stranded concertina wire to protect the 
perimeter—added to their concern. 

To stagger personnel departure dates and help train the new 82d 
pilots and crews in Dust Off flying, three of the 57th pilots transferred 
to the 82d, and three from the 82d transferred to the 57th. Maj. 
Henry P. Capozzi commanded the 82d; Maj. Howard H. Hunts¬ 
man, the 57th. The 82d used the 57th’s Hueys until it had its own in 
place and declared itself operational on 7 November 1964. 

The new unit retraced the steps of their predecessors. Soon after 
they started flying evacuation missions the pilots of the 82d had their 
first taste of Viet Cong resistance. On a mission near Bac Lieu on 27 
October, one of their new helicopters took three hits during a takeoff 
with casualties aboard. The crew flew back to Soc Trang and found 
one bullet hole through the red cross on one of the cargo doors. One of 
the ARVN evacuees lay dead from an enemy round that had 
penetrated the aircraft. 


40 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


The old question of a call sign soon came up. After considering 
various signs, including those used by helicopter ambulance units in 
Korea, the new commanders settled on the 57th’s sign, “Dust Off.” 
When the 82d also adopted the 57th’s unit emblem, merely changing 
the “57th” to “82d,” some of the former 57th pilots objected to this 
piracy. But the policy made sense, since both units performed the 
same mission and the common symbols helped the ground forces 
recognize the ambulance helicopters. 

One radical change was the conservative style of Capozzi and 
Huntsman. Both felt that the “wild and wooly days” ought to end and 
that the pilots of the 57th and 82d ought to temper their flying with 
cool judgment. They counseled their pilots to accept no missions 
without direct communication with the ground forces requesting the 
mission, to fly night missions only for extreme emergencies, and 
never to fly into an insecure landing zone. Despite these orders, the 
veterans of the 57th at Soc Trang quietly instilled the old elan in the 
new pilots, ensuring that the Kelly spirit stayed with Dust Off until 
the end of the war. 

In one area, however, Capozzi and Huntsman succeeded in end¬ 
ing a Kelly practice. They refused to allow their pilots to fly the Delta 
looking for patients. “Shopping for business,” they said, “is a waste of 
time.” They reasoned that the communication net was now secure 
enough to ensure speedy response to any call. The decision was 
sound. With five new helicopters. Dust Off no longer had to cover 
31,000 square kilometers with only two flyable aircraft. U.S. advisers 
could call or relay their mission requests directly to the air ambulance 
units via FM radio; ARVN units in the Delta routed their calls 
through the joint U.S.-ARVN Combat Operations Center at the 13th 
Aviation Battalion (U.S.). The aircraft pilots decided on missions. 
Air Force radar control at Can Tho provided its customary invaluable 
service; the rapport of USAF radar controllers with pilots of the 82d 
was as excellent as it was with those of the 57th. 

In other respects, Kelly’s teachings lived. As casualties mounted in 
the first months of 1965, the pilots of the 82d, despite their com¬ 
mander’s caution, flew many night missions. Since the Viet Cong 
usually attacked outposts and villages at night, and both sides pa¬ 
trolled and set ambushes at night, the Dust Off pilots too had to be 
abroad, seeking the wounded where they lay. 

The Crisis Deepens 

Late in 1964, the 271st and 272d Viet Cong Regiments merged and 
equipped themselves with new Chinese and Soviet weapons, forming 
the 9th Viet Cong Division. The 9th Division showed the value of this 
change in a battle for Binh Gia, a small Catholic village on Inter- 


BIRTH OF A TRADITION 


41 


provincial Route 2, sixty-five kilometers southeast of Saigon. On 28 
December and over the next three days the Viet Cong ambushed and 
nearly destroyed the South Vietnamese 33d Ranger Battalion and 4th 
Marine Battalion, and inflicted heavy casualties on the armored and 
mechanized forces that came to their rescue. The reorganized and 
reequipped Viet Cong were so confident that they stood and fought a 
four-day pitched battle rather than employ their usual hit-and-run 
tactics. The South Vietnamese suffered over 400 casualties and lost 
more than 200 weapons. Nearly eighty helicopters, including those 
from the 57th Medical Detachment, took part in the relief operations 
of this battle. During the fighting. Dust Off rescued nine crewmen 
from their downed helicopters and evacuated scores of South Viet¬ 
namese troops. 

Assistant Secretary of State William P. Bundy urged President 
Johnson to retaliate against North Vietnam. He was seconded by the 
new commander of the Military Assistance Command in Vietnam, 
Gen. William C. Westmoreland, and the U.S. ambassador to South 
Vietnam, Gen. Maxwell D. Taylor. Westmoreland thought that the 
Viet Cong seemed to be preparing to move from guerrilla tactics to a 
more conventional war. But President Johnson, ignoring his advisers, 
refused to allow an immediate bombing campaign against North 
Vietnam. 

Shortly afterward, however, Johnson himself lost confidence in 
current U.S. and South Vietnamese policy. On the morning of 7 
February the Viet Cong attacked the U.S. advisers’ base and airstrip 
at Camp Holloway near Pleiku. Mortar fire and demolitions killed 
several Americans, wounded more than a hundred, and destroyed 
five aircraft. Within hours forty-nine U.S. Navy fighter-bombers 
struck back at a North Vietnamese barracks just above the 
Demilitarized Zone. In his memoirs General Westmoreland called 
this strike a vital juncture in the history of American involvement in 
Southeast Asia. Within two days President Johnson approved a policy 
of “sustained reprisal” against the North. 

Along with the rest of the U.S. Army in Vietnam, Dust Off quick¬ 
ly felt the new surge of America’s war effort. From 1962 to early 1965 
the Dust Off pilots and their crewmen had been at school in Vietnam. 
Now they would have to show what they had learned, applying on a 
large scale the tradition of courage and unhesitating service that they 
had forged in the early years. 






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i 







CHAPTER III 


The System Matures 

Early in 1965 a growing number of Viet Cong attacks on U.S. 
personnel in South Vietnam prompted President Johnson to order all 
American dependents out of that country. On 22 February General 
Westmoreland asked for American combat ground forces to defend 
allied bases against Viet Cong attacks, and on 25 February Secretary 
of State Dean Rusk approved. On 8 March the first of these forces, a 
battalion landing team of the 9th Marine Expeditionary Brigade, 
debarked on the beaches at Da Nang. U.S. officials announced that 
the new troops would make several key bases more secure, thereby 
freeing the South Vietnamese forces to press the war more vigorously. 
But the Viet Cong continued their terrorist campaign. On 30 March 
they detonated a powerful bomb outside the hotel housing the U.S. 
Embassy in Saigon. The explosion killed twenty-one people, in¬ 
cluding two Americans, and wounded two hundred others, including 
fifty-two Americans. 

After a lull in the fighting while the Viet Cong waited out the dry 
season, which favored the superior mobility of the ARVN forces, the 
countryside erupted in May. A Viet Cong regiment attacked Song 
Be, the capital of Phuoc Long province in northern III Corps Zone. 
Soon a more serious blow came when the rebels ambushed an ARVN 
battalion and destroyed the column sent to its aid. In June the enemy 
again dealt the ARVN forces a heavy blow at Dong Xoai, ninety-six 
kilometers northeast of Saigon. June also brought the collapse of the 
current South Vietnamese governing coalition, and the new rulers. 
Generals Nguyen Van Thieu and Nguyen Cao Ky, seemed to have 
little chance of ending the recent years of political instability. In July 
the fighting shifted to the Central Highlands of II Corps Zone, where 
the South Vietnamese suffered a series of defeats. 

This military and political deterioration in 1965 produced a rapid 
increase in U.S. aid to South Vietnam. Within a few months of their 
arrival in March, the first U.S. combat units in South Vietnam began 
search-and-destroy operations against the Viet Cong near U.S. bases. 
By the end of the year evidence of increased North Vietnamese in¬ 
filtration of the South helped General Westmoreland to obtain 
substantial reinforcements of U.S. combat troops. A U.S. troop 
buildup continued steadily until March 1968 as the United States ex- 


369-454 0-82 


4 


44 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


panded its effort to destroy the political and military influence of the 
National Liberation Front. 


Origins of the Air Ambulance Platoon 

As more soldiers arrived, the Army Medical Service began its own 
buildup, which included an increase in the number of medical 
evacuation units. During the next three years the Surgeon General of 
the Army sent two air ambulance companies and six more helicopter 
ambulance companies to Vietnam. In March 1966 the 44th Medical 
Brigade, which had been activated in January, assumed control of 
most Army medical units in Vietnam. Over the next two years the 
brigade began to coordinate the work of the 68th Medical Group 
(responsible for III and IV Corps Zones), the 43d Group (South II 
Corps Zone), the 55th Group (North II Corps Zone), and the 67th 
Group (I Corps Zone). These medical groups, with the exception of 
the 55th, which left aeromedical evacuation in its area to the 43d 
Group, commanded all the nondivisional air ambulances —the com¬ 
panies and detachments. In late 1965, with the Surgeon General’s 
permission, American combat forces also brought in Medical Service 
Corps pilots to man the aircraft of a new form of medical evacuation 
unit: the air ambulance platoon. Unlike the air ambulance units of 
the 44th Brigade, it would depend on its combat assault division for 
command and supply. 

The platoon owed its existence to the creation of the first airmobile 
division in the U.S. Army, the 1st Cavalry Division (Airmobile). In 
August 1962 the U.S. Army Tactical Mobility Requirements Board, 
chaired by Lt. Gen. Hamilton H. Howze, had recommended the 
creation of a new airmobile division, which would be served by an air 
ambulance platoon. Outlining the probable nature of airmobile war¬ 
fare the Board had assumed that 

... all categories of patients within the theater of operations will be evacuated 
by air. AMEDS aircraft organic to the division will evacuate casualties from 
forward pickup sites and/or aid stations to clearing stations or Mobile Army 
Surgical Hospitals. Air Ambulance companies assigned to corps and field 
Army will evacuate casualties from the clearing stations and surgical 
hospitals to evacuation hospitals. 

Although the air ambulance battalion would use several types of 
helicopters, the air ambulance platoon would usually consist of only 
twelve UH-l’s. 

In early 1963 the Army decided to test the precepts laid out by the 
Howze Board. On 7 January the Deputy Chief of Staff for Operations 
issued instructions for the creation of an experimental air assault divi¬ 
sion. The unit was organized in February at Fort Benning, Georgia, 


THE SYSTEM MATURES 


45 


and named the 11th Air Assault Division (Test). Its commander was 
Brig. Gen. Harry W. O. Kinnard. 

The division was composed of eight infantry battalions (expanded 
to nine in Vietnam) organized into three brigades: three battalions 
each for the 1st and 2d Brigades and two for the 3d Brigade. One 
brigade had an airborne capability. An artillery battalion in each 
brigade provided ground-to-ground fire support and an Aerial Rocket 
Artillery Battery provided air-to-ground support. The thirty-six 
UH-lB’s of the aerial rocket battery each carried seventy-two folding 
fin rockets, and most also carried externally-mounted M60 machine 
guns. An aviation battery of sixteen light observation helicopters 
coordinated the division’s artillery. Two assault helicopter battalions 
each had sixty unarmed helicopters, organized into three companies 
of twenty ships each. Both battalions had an armed helicopter com¬ 
pany of twelve UH-IB gunships, each carrying four MGO’s and fif¬ 
teen rockets. As the Howze Board had suggested, the Air Ambulance 
Platoon, a structurally new aeromedical evacuation unit, fell under 
the division’s medical battalion. 

Air Assault I, a field exercise held at Fort Stewart, Georgia, in 
September and October 1963, tested the control capabilities of the air 
assault battalion and company, and the problems of the air ambulance 
platoon. This exercise and others held at Forts Benning and Gordon sug¬ 
gested that the platoon could effectively support the Air Assault Division 
without the benefits of a superior company command. Faulty com¬ 
munications equipment and the limited capacity of the UH-lB’s were 
the only serious problems affecting the platoon’s performance. 

The experimental 11th Air Assault Division was disbanded soon 
after the testing in Georgia, but its components and the resources of 
the 2d Infantry Division at Fort Benning were combined and given 
the name of the 1st Gavalry Division, which had been on duty in 
Korea since 1950. The new division, the 1st Gavalry Division (Air¬ 
mobile), had roughly 16,000 men, the standard allotment. But it had 
4 1/2 times the standard number of aircraft and one-half the standard 
number of ground vehicles. It acquired almost one thousand aviators 
and two thousand aviation mechanics. The creation of this division 
opened a new phase in U.S. Army warfare. 

The Air Ambulance Platoon, which consisted of twelve helicopters 
and their crews, was an integral part of the new division, and deployed 
with it to the mountainous Gentral Highlands of South Vietnam in 
August 1965. It served as part of the division’s 15th Medical Bat¬ 
talion. It not only offered medical evacuation to wounded soldiers of 
the 1st Gavalry but also had the equipment to rescue pilots of crashed 
and burning aircraft. It consisted of a medical evacuation section of 
eight helicopters and a crash rescue section of four helicopters. It also 
had three Kaman “Sputnik” fire suppression systems to enable the 


46 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


crash rescue teams to enter burning aircraft. Unfortunately, if the air¬ 
craft fitted with the Sputnik system also carried its full complement of 
two firemen, a crew chief, a medical corpsman, and two pilots, it 
could not lift off unless the crew had drained the fuel tanks to 400 
pounds or less. After its arrival in Vietnam the platoon found that 
maintenance problems, general aircraft shortages, and regular evacu¬ 
ation missions made it impossible to keep four of its aircraft ready at 
all times for crash rescue missions. 

Unlike the helicopter detachments and companies of the 44th 
Medical Brigade, the platoon’s pilots used “Medevac” as their call 
sign. However, they resembled the pilots of the older units in their 
methods, training, and outlook. Like the commissioned Dust Off 
pilots, the platoon’s officer pilots had graduated from the helicopter 
program of the U.S. Army Aviation School at Fort Rucker, Alabama, 
and had been trained in emergency resuscitative medicine by the Army 
Medical Department. 

The Air Ambulance Platoon Goes to Work 

After the 1st Cavalry began to dig in on the An Khe plain in early 
September 1965 the platoon’s pilots flew their first missions and 
quickly tasted some Viet Cong resistance. To protect the platoon’s 
aircraft, the division began keeping gunships on call for escort. The 
platoon’s pilots, however, thought that traveling with the slower, 
heavier gunships wasted precious minutes of response time. 

During the next three years, a period of large search-and-destroy 
operations, medical aircraft often accompanied ARVN and U.S. 
forces to the battlefield. In the remote Central Highlands the 1st 
Cavalry’s air ambulance platoon found it wise to conform to the 
Howze Board report by evacuating its patients only as far as the bat¬ 
talion aid stations or division clearing stations. Nonorganic air am¬ 
bulances commanded by medical authorities would then backhaul the 
casualties to the 71 st Evacuation Hospital at Pleiku or to hospitals further 
away, on the coast. Later in the war, when the 1st Cavalry moved to III 
Corps Zone, the platoon itself began to make evacuation flights from 
the site of wounding directly to hospitals. 

In time the platoon would prove its value, but some of its early ex¬ 
periences were not encouraging. On 19 September four of the 
platoon’s ships supported an early 1st Cavalry operation. Because of 
poor coordination and misplaced concern on the part of ground per¬ 
sonnel, the transport helicopters carried out the casualties and the air 
ambulances carried out the dead. 

On 10 October one of the platoon’s pilots, Capt. Guy Kimsey, 
answered an evacuation request from a ground unit sixty kilometers 
east of An Khe. While Kimsey loaded his ship, a Viet Cong round hit 


THE SYSTEM MATURES 


47 


the engine and shut down the aircraft. Another helicopter flew the 
crew and patients back to An Khe, where Kimsey told the 15th 
Transportation Battalion that he had a downed ship. The main¬ 
tenance unit sent out an aircraft recovery team the same day, but the 
team could not find the ship and accused the pilot of giving them the 
wrong coordinates. Rankled, Kimsey climbed into the recovery air¬ 
craft and flew the team chief on the spot. At first, as they approached 
the area at some distance, Kimsey thought the chief might be right. 
But as he drew nearer he saw the outline of a helicopter on the 
ground. They landed. All that he could find of his ship was part of the 
tail rotor. He checked with the ground troops in the area who had 
called in the evacuation request. From them he learned that when the 
Viet Cong had earlier tried to overrun the position, the U.S. troops 
had called in friendly artillery. One of the rounds had scored a direct 
hit on the disabled helicopter. 

Misfortune struck again on 10 October during Operation Shiny 
Bayonet near An Khe. Three of the platoon’s ships flew out to 
evacuate eleven seriously wounded soldiers from the 3d Brigade. As 
they approached the landing zone at 1630, they saw the fires from Air 
Force tactical strikes still burning. A firefight also raged, and the 
ground commander radioed that the landing zone was insecure. The 
senior pilot elected to stay at high altitude with his Huey gunship 
escort and one other Medevac ship while the third ship made a low 
approach to the pickup zone. As he took his aircraft in, the pilot of the 
third ship, Capt. Charles F. Kane, Jr., was struck in the head by an 
enemy bullet. His copilot flew the aircraft to the 85th Evacuation 
Hospital, where Kane became the platoon’s first fatality. 

By mid-October the North Vietnamese Army had begun its drive 
against allied forces in the Central Highlands. In supporting the 
ARVN forces that tried to repulse this attack, the 1st Cavalry and its 
Air Ambulance Platoon received their first severe test. By early Oc¬ 
tober the 32d and 33d North Vietnamese Regiments had infiltrated 
western Pleiku Province between the Cambodian border and Plei 
Me, a Special Forces base camp forty-three kilometers south of 
Pleiku. Route 6C stretched north from Plei Me toward Pleiku. A 
third unit, the 66th North Vietnamese Regiment, was soon to arrive. 

On 20 October the 33d North Vietnamese Regiment attacked four 
South Vietnamese Civilian Irregular Defense Group (CIDG) com¬ 
panies at Plei Me. The North Vietnamese 32d Regiment lay in ambush 
for the ARVN forces expected to move south from Pleiku. On 23 Oc¬ 
tober the ARVN armored relief force left Pleiku and marched south 
toward Plei Me, covered by the artillery of the 1st Cavalry Division. 
On the afternoon of the 24th, Air Ambulance Platoon helicopters car¬ 
ried an artillery liaison party into the column and returned with some 
noncombat-injured soldiers. At 1750 the Communist ambush struck 


48 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


the convoy, but the ARVN troops broke out and reached the beseiged 
camp the following day. 

Over the next month the 1st Cavalry Division and ARVN forces 
continued to fight over this territory in the battle of the la Drang 
Valley. On 27 October General Westmoreland ordered Maj. Gen. 
Harry W.O. Kinnard, 1st Cavalry Division commander, to conduct 
search-and-destroy operations in western Pleiku Province. For the 
first time the division’s mission was unlimited offense. 

In this battle the Air Ambulance Platoon proved its worth. Early 
in November Lt. Col. Harold G. Moore took his cavalry battalion by 
helicopter into a landing zone near the Cambodian border. The newly- 
arrived 66th Regiment and the remnants of the 33d Regiment waited on a 
mountain overlooking the landing zone. Heavy enemy fire from these 
regiments restricted helicopter approaches and departures, and 
friendly casualties began to mount. The battalion surgeon, with 
medical supplies and four medical corpsmen, flew in under heavy 
enemy fire on an Air Ambulance Platoon ship and immediately began 
treating the casualties. This saved the lives of many soldiers who 
could not have survived a long wait for evacuation. By that night the 
Air Ambulance Platoon and returning gunships had evacuated all the 
wounded. Although the gunships had helped, the brunt of the evacua¬ 
tion burden had fallen on the Air Ambulance Platoon, which had per¬ 
formed superbly. 

At the start of the la Drang campaign the Air Ambulance Platoon 
operated twelve aircraft. One was destroyed on 10 October 1965, four 
were usually down for maintenance, two were required for division 
base coverage at An Khe, and two supported the operations of the 
Republic of Korea (ROK) forces east of An Khe. To support the 
nearly three thousand men of a reinforced brigade, which was the 
average strength committed at any one time to the la Drang, the 15th 
Medical Battalion now had only three aircraft to site forward. The 
casualties varied, but averaged 70 to 80 a day, with 280 on the worst 
day. Fortunately the troop ships carried the less critically injured men 
from the landing zones, easing the platoon’s load. 

In his after-action report. Colonel Moore described another problem 
he had met in his medical evacuation: the heavy enemy fire and the 
dense 100-foot high trees had prevented the platoon from evacuating 
men from the spot where they were wounded. The ground troops had 
had to move many of the wounded to a single secure landing zone. 
Moore reported: “I lost many leaders killed and wounded while 
recovering casualties. Wounded must be pulled back to some type of 
covered position and then treated. Troops must not get so concerned 
with casualties that they forget the enemy and their mission. Attempt¬ 
ing to carry a man requires up to four men as bearers which can hurt 
a unit at a critical time.” The solution, which came later, involved a 


THE SYSTEM MATURES 


49 


technical innovation rather than restraining the soldier’s natural con¬ 
cern for his wounded comrades. 

By mid-November the 15th Medical Battalion and its Air Am¬ 
bulance Platoon were short five pilots and fifty-six enlisted men. Of 
the twelve Medical Service Corps pilots authorized the platoon, one 
was dead, one was injured, and the battalion commander had placed two 
on his staff and had reassigned another who had only four months re¬ 
maining in his tour of duty. The commander asked for replacements, but 
none could be found because all units were short of men. 

Saturday, 18 December, was another dark day for the Air Am¬ 
bulance Platoon. Capt. Walter L. Berry, Jr., pilot, and WOl George 
W. Rice, copilot, had just settled to the ground at a pickup site to 
evacuate two 1st Cavalry wounded when an enemy soldier opened 
fire on the helicopter from the left. One bullet, entering through the 
open cargo door, struck Rice in the head. Another hit the crew chief 
in the hand. Berry raced to the nearest clearing station, but Rice died 
there within an hour, the first warrant officer in the Medical Service 
Corps Aviation Program to be killed in action. The Medevac ship had 
been unescorted and unarmed. Shortly thereafter the platoon com¬ 
mander, Maj. Carl J. Bobay, wrote: “Within three months of opera¬ 
tions in Vietnam, two pilots have been killed, one enlisted man 
wounded, and nine helicopters shot up, all due to enemy action. 
Believe me.. .we are not proud of these statistics. What the next eight 
months may hold in store for us is too much to even consider.” 

During this period more of the regular medical detachments were 
deploying in the two southern Corps Zones. The 283d Medical 
Detachment (Helicopter Ambulance), activated at Fort Lewis, 
Washington, landed at Saigon on 1 September 1965 and started to 
help the 57th cover III Corps Zone. In November 1965, the 254th 
Medical Detachment (Helicopter Ambulance) also arrived at Tan 
Son Nhut Airport, Saigon. The two ships that had sailed from 
Tacoma, Washington, with all the 254th’s equipment, reached the 
South Vietnamese coast on 29 October but could not be unloaded until 
mid-January because of the congestion in the ports. Until then some 
of the 254th’s pilots worked with the 283d and 57th. The 254th 
declared itself operational on 1 February at Long Binh with the 
primary mission of direct support for the 173d Airborne Brigade on its 
sweep operations in III Corps Zone. The 57th and 283d supported the 
other allied units in the sector. 

The Medical Company (Air Ambulance) 

In September 1965 another new type of medical evacuation unit 
deployed in Vietnam—the medical company (air ambulance). The 
1959 table of standard equipment for such a unit provided for twenty- 


50 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


four two-patient helicopters, served by twenty-eight officers and a 
larger group of enlisted men. In September 1964 the 498th Medical 
Company (Air Ambulance) was activated at Fort Sam Houston, 
Texas, where it served in a standby utility capacity until June 1965. 
That month the company received twenty-five new UH-lD’s fresh 
from the Bell Helicopter Plant, and the pilots set to work learning the 
new machine. 

At Camp Bullis, a subpost of Fort Sam Houston nineteen miles 
northwest of San Antonio, the company conducted instrument train¬ 
ing and practiced the tactics of day and night flying. On most days the 
flight crews and their instructors took off at 0600 and were still out fly¬ 
ing at 2100. All crew members also had some target practice with the 
M14 rifle and the .45-caliber pistol. Crew chiefs and medical corps- 
men practiced firing from the open cargo doors of an airborne 
helicopter. Most of the flight practice simulated the low-level naviga¬ 
tion and approaches that the instructors had learned flying over the 
Delta in South Vietnam. Because of the varied military occupational 
specialties of the enlisted men, Lt. Col. Joseph P. Madrano, com¬ 
mander of the 498th, convinced Maj. Gen. William Harris, the post 
commander, to let the 498th tailor its own unit training program. 
General Harris not only agreed but also had his staff prepare training 
aids, and he himself visited the unit almost daily to see if he could do 
more to help. 

On 24 July 1965 a Department of Army message arrived assign¬ 
ing the 498th to U.S. Army, Pacific, destination unstated. Last 
minute efforts to obtain and pack supplies, aided greatly by General 
Harris, drew to a close. The 498th planned a well-deserved party for 
the men and their families at Salado Creek Park in Fort Sam Houston. 
General Harris, whom they invited, first suggested then insisted that 
the unit find a civilian UH-1. He wanted the families to have at least 
one flight in a Huey to see the aircraft that their fathers, sons, and 
husbands flew. The Bell Helicopter Corporation cooperated and 
everyone got to ride in a helicopter. 

Shortly after he flew into Nha Trang with the advance party of 
the 498th, Colonel Madrano went to Saigon where the Surgeon of the 
U.S. Army, Vietnam (USARV) told him that the company would 
cover the entire II Corps Zone from a base or bases of Madrano’s 
choosing. In the early fall of 1965 the only American combat unit in II 
Corps Zone was the 1st Brigade of the 101st Airborne Division (Air¬ 
mobile), which usually operated north of Qui Nhon. Several Special 
Forces camps monitored the border and a few ARVN units also work¬ 
ed the area. But these forces grew quickly after the arrival of the 1st 
Cavalry. 

The company organization for air ambulances was unprecedented 
in Vietnam. The only other experience of an air ambulance company 


THE SYSTEM MATURES 


51 


the 498th could draw on was that of the 421st Medical Company in 
Europe, which had its platoons, each consisting of six ships, scattered 
at four bases. Some pilots of the 498th wanted a similar dispersion 
while others preferred a centralized operation. Colonel Madrano told 
the Surgeon that he wanted to place a platoon each at Nha Trang, 
Qui Nhon, Pleiku, and Ban Me Thuot, the only secure bases in II 
Corps Zone that could possibly support them. All had inadequate 
resources to accept the entire company. Madrano soon dispersed his 
unit: 1 1/2 platoons at Qui Nhon; 1 1/2 platoons near the 52d Avia¬ 
tion Battalion at Pleiku; and the fourth platoon, along with the com¬ 
pany headquarters, maintenance section, and operations section, at 
Nha Trang. Since the Qui Nhon contingent shared its compound 
with the 117th Aviation Company, some of the platoon’s Medical Ser¬ 
vice Corps pilots had an opportunity to fly a few assault missions and 
learn about life as combat pilots. The technique the 117th taught was 
to fly out high, circle down steeply to the landing zone, and always 
keep the target in sight. This was a radical contrast to the techniques 
the 498th had practiced in Texas. The low-level approaches they had 
practiced at Camp Bullis had ill-prepared them for work in the moun¬ 
tainous Central Highlands of II Corps Zone. 

When it first became operational on 20 September, the 498th 
was authorized only one-half the pilots it needed, so the USARV 
Surgeon and the 1st Logistical Command pitched in to help. 
Nonmedical commissioned and warrant officer pilots were sent on 
temporary duty to the 498th. Some of these men were at first reluctant 
to leave their gunships and transports, but toward the end of their 
term with the 498th most wanted to stay longer. 

The distance of the deployed 498th platoons from their control 
headquarters in Saigon, the 1st Logistics Command, helped create a 
familiar problem. Each commander in II Corps Zone thought that 
some Of all of the air ambulances belonged to him. Each thought that 
the authority to dispatch a flight should be his and that his isolated 
posts deserved individual Dust Off coverage. The problem was not 
alleviated by the assignment in late September of the 498th to the 43d 
Medical Group. Madrano had to exercise firmness to preserve the 
498th’s independence. 

The disposition of his platoons compounded Madrano’s problem 
of controlling his company. While the dispersion provided excellent 
air ambulance support to tactical combat units, it also created 
monumental problems for the company. Maintenance had to be carried 
on at three sites while the entire maintenance platoon was stationed at 
Nha Trang. Madrano was in the air constantly, visiting platoons or field 
sites, coordinating operations, and often flying hot missions from his 
three bases. 

November turned out to be an especially trying month for 


52 DUST off: army AEROMEDICAL evacuation in VIETNAM 

everyone in the 498th —pilots, crews, and maintenance men. On 11 
November one of the aircraft flew from Qui Nhon to pick up a wounded 
South Korean soldier. At the landing zone, just as the medical corps- 
man finished loading the patient, enemy soldiers opened fire on the 
aircraft; one round hit the pilot in the neck. The copilot looked to his 
left, saw the pilot’s bloody wound, and grabbed the controls. By now 
the North Vietnamese had begun to surround the aircraft. Drawing 
on all the power he could, with no regard for the torque meter, the 
copilot made a low-level takeoff straight at the enemy. The crew chief 
leaned out the open cargo door and used an M14 as a club. The air¬ 
craft returned to Qui Nhon and the pilot was rushed to an emergency 
room. He survived, and later returned to the United States to 
recover. 

On the night of 11 November an aircraft of the 4th Platoon 
responded to an evacuation request from a South Korean unit west of 
Qui Nhon. Once over the landing zone they descended rapidly. Near 
the ground the windshield suddenly fogged over and neither pilot 
could see outside the cockpit. Before they could reorient themselves 
and halt their descent the helicopter crashed on a mountain and burst 
into flames. The copilot managed to pull the pilot from the wreck but 
the other crewmen perished. Both pilots suffered serious burns and 
were evacuated to Japan. The next morning a ground ambulance 
evacuated the Korean casualties. 

The 436th Medical Company (Provisional) 

The next air ambulance company set up in South Vietnam was 
drawn mainly from detachments already in the country. In April 1965 
Lt. Col. James W. Blunt, the Surgeon of the U.S. Army Support 
Command, Vietnam, complained about the common practice of 
casualty evacuation by nonmedical aircraft. He planned an increase 
of at least two more air ambulance detachments in Vietnam to help 
counter this practice. The commander of the new 82d Medical 
Detachment suggested that he also create a control unit, possibly a 
provisional company, to command the proposed four air ambulance 
detachments. Later in the year Col. Ralph E. Conant, Colonel 
Blunt’s successor, decided that such a control unit would indeed 
reduce the current confusion in III and IV Corp Zone medical 
evacuation caused by the wide dispersion of the four detachments and 
by their erratic communications. By November he had started plan¬ 
ning for a provisional air ambulance company composed of four 
detachments, analogous to the four decentralized platoons of the 
498th Medical Company. 

On 1 December 1965 the Medical Company (Air Ambulance) 
(Provisional) was created from the old 57th and 82d Detachments, 


THE SYSTEM MATURES 


53 


and the new 254th and 283d Detachments. The 43d Medical Group, 
which already commanded the 498th Medical Company, now took 
control of the provisional company. The company’s mission was to 
supervise all aeromedical evacuation in III and IV Corps Zones. The 
units first commander, Maj. Glenn Williams, immediately asserted 
his authority by having the 57th Detachment removed from the 
operational control of the 145th Aviation Battalion and the 82d 
Detachment from the 13th Aviation Battalion. Believing his first com¬ 
plement of personnel inadequate to supervise four widely separated 
detachments, Williams pushed his superiors to expand his staff. On 1 
April he received permission to form a company headquarters of two 
officers and six enlisted men, who would supervise 46 officers and 114 
enlisted men. The company operated twenty-two helicopters (five 
each for the 57th and 82d Detachments, and six each for the 254th 
and 283d Detachments). 

The creation of the provisional company was expected to improve 
the coordination of the air ambulance detachments. But company 
newsletters and personal letters from its men show that the new unit 
was not a success. Each detachment retained its own identity and 
tended to regard the company as just another headquarters in the 
chain of command. Major Williams also found, as had Colonel 
Madrano in the 498th, that the unique mission and problems of the 
air ambulance units required a battalion-size staff instead of a com¬ 
pany headquarters. No doubt more lives could have been saved if an 
aggressive battalion safety officer had been available. More 
helicopters could have flown if a battalion maintenance officer had 
been able to coordinate and supervise the work of the young detach¬ 
ment maintenance officers. Although U.S. warehouses were full of 
the latest flight and safety equipment, the pilots and crew members 
were seldom able to obtain it, since a young officer with no supply 
training, representing a small detachment, had little chance of finding 
his way through the maze of supply channels. 

But Major Williams was unable to set up more than a small provi¬ 
sional company headquarters. In September 1966 the Provisional 
Company was renamed the 436th Medical Detachment (Company 
Headquarters) (Air Ambulance) and attached to the 68th Medical 
Group, which had become operational in Vietnam on 1 March. This 
name lasted until May 1967 when the 436th was renamed the 658th 
Medical Company. With the arrival of the 45th Medical Company 
(Air Ambulance) in July 1967, the 658th was deactivated and the 57th 
and 82d Detachments were attached to the 45th. The 283d moved to 
Pleiku and the 254th to Nha Trang. Overall, the experiment had failed. 

ATTLEBORO 

In late 1966 Operation Attleboro, the largest combined 


54 DUST off: army AEROMEDICAL evacuation in VIETNAM 

U.S.“South Vietnamese operation since the start of the war, gave the 
medical evacuation system its severest test so far in Vietnam. Over 
20,000 allied soldiers were embroiled in a struggle with a large enemy 
force moving against objectives in Tay Ninh Province. 

In October 1966 the 101 st North Vietnamese Regiment and two 
regiments of the 9th Viet Cong Division began to move east from their 
sanctuaries along the Cambodian border. One of the regiments aimed 
at the Special Forces camp at Suoi Da, hoping to draw allied units in¬ 
to an ambush by the other 9th Division regiments. By the end of 
November the 1st Infantry Division, the 173d Airborne Brigade, and 
elements of the 4th and 25th Infantry Divisions entered the struggle. 
Even while dealing the Communist forces a severe setback the allied 
forces suffered heavy casualties. Friendly losses were 155 killed and 
494 wounded. 

During Attleboro the 436th Medical Company flew continuous 
missions. In two of the battles all the company’s aircraft were in ac¬ 
tion. By the end of November the Dust Off helicopters had brought 
some 3,000 wounded, injured, and sick soldiers in from the field, aid¬ 
ed for the first time by newly-installed hoists: winches that allowed 
soldiers to be lifted to hovering aircraft.^ In the month-long operation 
the enemy hit fourteen Dust Off helicopters, heavily damaged seven, 
and destroyed one. 

One serious problem in the coverage by the air ambulances 
marred an otherwise impressive performance. Each of the four U.S. 
combat units in Attleboro controlled its own Dust Off aircraft. Since 
the medical regulating officers with each combat unit rarely coor¬ 
dinated their unit’s Dust Off missions with the other dispatchers, the 
air ambulance with a unit in battle flew a great deal while the other 
aircraft flew very little or not at all. Corrections were clearly in order. 

The Dust Off system soon, almost too soon, had a chance to show 
what it had learned in Attleboro. On 8 January 1967 twenty U.S. 
and ARVN units launched Operation Cedar Falls by penetrating 
the Iron Triangle northwest of Saigon. Over the next nineteen days 
the allied combat units sealed off, searched out, and destroyed Com¬ 
munist camps and troop concentrations throughout the area, killing 
720 enemy soldiers. 

During the planning stages of the operation the commander of the 
436th had talked with Army staff about the medical evacuation prob¬ 
lems he had seen during Attleboro. With the staff’s help he was able 
to establish a control net for dispatching and following all the Dust Off 
aircraft in Cedar Falls. All Dust Off requests during the operation 
funneled through two central dispatch agencies. Two Dust Off 
detachments then divided the battlefield, each supporting the units 


1 


See Chapter IV for a description of the hoist and various litters. 


THE SYSTEM MATURES 


55 


within its area. Between flights, pilots regularly stayed some time at 
the regulating sites to help coordinate missions. Much wasteful 
duplication of effort was eliminated; the Dust Off system had been 
further improved. 


The 45th Medical Company 

During 1967 a new medical company, the 45th, brought in new 
equipment and pilots. In July 1966 the 44th Medical Brigade, which 
had become operational 1 May, asked the U.S. Army, Vietnam, to 
deploy another air ambulance company. Col. Ray L. Miller, brigade 
commander, noted that since January monthly medical evacuations 
in South Vietnam had risen from three thousand to over five thou¬ 
sand. Combat damage was taking a heavy toll on the Dust Off air¬ 
craft. But Miller’s superiors decided to wait for the arrival of some 
new air ambulance units already scheduled for Vietnam. As an in¬ 
terim measure they assigned six nonmedical helicopters to the evacua¬ 
tion units, three for each of the two air ambulance companies. The 
45th’s deployment was postponed a year. 

In March 1967 General Westmoreland told the Commander in 
Chief, U.S. Army, Pacific, that his theater needed 120 air ambulances 
but had only 64 on hand. Even if he received forty-nine more, to which 
the approved troop list entitled him, he would lack seven aircraft. In 
April the U.S. Army, Vietnam, informed U.S. Army, Pacific, that in 
light of its growing forces, it had taken several steps to reduce the shor¬ 
tage of air ambulances. Its stopgap measures included giving the 498th 
and 436th air ambulance companies more nonmedical aircraft, giving 
basic medical training to those assault and transport crewmen who might 
find themselves evacuating the wounded, and even designating certain 
aircraft in the airmobile assault units to carry a medical corpsman during 
attacks. Since he thought that these measures were makeshifts only, 
Westmoreland urged that the new air ambulance company and four 
detachments be shipped to South Vietnam as soon as possible. 

By mid-1967 U.S. troop strength in South Vietnam approached 
450,000, and General Westmoreland was asking for even more soldiers. 
U.S. Army, Vietnam, at last asked for another air ambulance company 
and four more helicopter ambulance detachments. If granted, this re¬ 
quest would place a total of 109 air ambulance helicopters in South Viet¬ 
nam. 

In late May 1967 the 45th Medical Company (Air Ambulance), sta¬ 
tioned at Fort Bragg, North Carolina, received notice that it would soon 
leave for Vietnam. It had been on deferred status since 1965 with twenty- 
five obsolete H-19 helicopters. Since the company was unable to acquire 
its last twelve authorized pilots before departure, it deployed without the 
pilots for one entire flight platoon; too many aviation units were forming 


56 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


and deploying for all to have their full complement of pilots. Before 
departing, the unit picked up twenty-five new UH-lH’s with powerful 
Lycoming L--13 engines. These aircraft could be fitted with hoists for in¬ 
flight loading of the wounded, and they also carried new DECCA 
navigational kits. By 13 September the 45th was fully operational at 
Long Binh, about twenty kilometers northeast of Saigon. The airfield 
section leader kept some of his men busy building a heliport tower, and 
proved adept at scrounging. His crash rescue team soon had a bright red 
fire truck. He liberated a 3,000-gallon fuel bladder for JP-4 helicopter 
fuel and another with pumps for the aircraft washrack. 

The 45th soon committed itself to giving twenty-four hour standbys 
at several bases around Saigon. One aircraft also gave daylight support 
to the Australians in the Saigon area. At Long Binh the com¬ 
pany kept three standby aircraft for nearby evacuations and another 
for VIP or medical administration missions. From June through 
September alone, nine of the aircraft were damaged in combat. In 
October the 93d Evacuation Hospital started using the 45th to 
transfer most of its patients to a casualty staging facility near Tan Son 
Nhut, saving the injured the discomfort of riding in ground am¬ 
bulances over the congested and dusty streets of Saigon. 

The Buildup of 1967 

Overall, this was a year of massive buildup for U.S. Army forces 
in Vietnam. Parts of I Corps Zone, until then a U.S. Marine Corps 
responsibility, went Army. U.S. Army, Vietnam, received not only 
the 45th Medical Company, but also four new air ambulance 
detachments. The Dust Off units already in Vietnam were moved to 
obtain better coverage for the newly deployed troops. The 54th 
Medical Detachment (Helicopter Ambulance) arrived at Chu Lai in 
the southern I Corps Zone in August, immediately began combat 
training with the 498th Medical Company, and became operational 
on 25 September 1967. It supported the Americal Division, the 
Army’s largest. The southern I Corps Zone proved to be one of the 
most hotly contested in South Vietnam, and the 54th soon amassed 
an enviable record of honorable and dedicated support. 

Other medical units followed. In October the 159th Medical 
Detachment (Helicopter Ambulance) arrived in Cu Chi, twenty 
kilometers northwest of Saigon with a mission to support all units in 
the area, but primarily the U.S. 25th Infantry Division. In November 
the 571st Medical Detachment (Helicopter Ambulance) joined the 
254th at Nha Trang. It did not become operational until 2 January 
1968, because the congestion in the ports delayed the unloading of its 
equipment. In December the 50th Medical Detachment (Helicopter 
Ambulance) arrived at its base at Phu Hiep, in the southwestern II 


THE SYSTEM MATURES 


57 


Corps Zone, and assumed responsibility for the 173d Airborne 
Brigade, the 28th ROK Regiment, and all other forces in the vicinity. 
The day after its helicopters arrived, the 50th went into action. By the 
end of December it had evacuated 644 patients, including 100 Koreans. 

One of the more dramatic missions flown in this buildup phase of 
the war occurred on 18 October 1966 when a Dust Off craft from the 
82d Detachment flew a hot mission near Vi Thanh in the Delta. As 
the crew approached the landing zone and slowed their ship, the 
enemy opened up with heavy and light automatic weapons fire from 
three sides. The ship broke off its approach and went around for 
another try. On the second attempt it took several more hits, some in 
the fuel cells. Its fuel quantity gauge registered zero and it departed 
for a safer landing site. After the first Dust Off had cleared the area, a 
transport helicopter tried to get in and pull out the casualties. As soon 
as it neared the ground the enemy took it under fire, killing the pilot 
outright. The aircraft crashed in some trees at the edge of the landing zone. 

When they saw how hot the pickup site was, a second Dust Off 
crew decided to land some two hundred meters from the crashed 
transport. As they neared their new site they took one hit in the fuel 
cell. Another round hit the electronics compartment, popped half the 
overhead circuit breakers, destroyed the compass, and lit up the 
master warning lights. The crew landed anyway, but the patients 
would not come out to the ship since mortar rounds began hitting the 
area. So Dust Off flew out and struggled back to Vi Thanh for 
maintenance work. 

A third Dust Off crew radioed a nearby gunship that they would 
like to follow him in after he prepared the landing zone to make the 
Viet Cong keep their heads down. The gunship started in with Dust 
Off following. Enemy fire wounded both crew members on the armed 

UH-IC, nicknamed the “Huey Hog,” but Dust Off continued in and 
this time managed to land. As soon as they touched down the crew 
chief and medical corpsman jumped out and started loading 
casualties, even though the enemy harassed them with rifle and mor¬ 
tar fire. They loaded four litter and eleven ambulatory patients, and 
signaled the pilots to take off. The pilot drew on his maximum power 
as they flew out to safety. 

Riverine Operations 

Apart from the drama of even routine evacuations, the Dust Off 
pilots working the Delta in this phase of the war had to cope with a 
new problem —furnishing medical evacuation for the joint riverine 
operations conducted by the U.S. Navy’s River Assault Flotilla One, 
Task Force 117, and the 2d Brigade of the Army’s 9th Infantry Divi¬ 
sion. Medical support for waterborne forces usually went with them 


58 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


down the rivers. One company of the 9th Medical Battalion staffed an 
armored riverine landing craft that was specially fitted with five bunks 
for patients. A helipad on the troop carrier consisted of little more 
than steel runway matting welded over a framework of pipe. Starting 
in May 1967 similar armored troop carriers, besides their six Navy 
crewmen, housed a medical team consisting of a battalion surgeon, 
medical assistants, and a radio-telephone operator. The normal route 
of evacuation was from the battlefield to the troop carrier by helicopter, 
then further evacuation by helicopter to a surgical or evacuation hos¬ 
pital. So the armored troop carrier with its medical complement was 
similar to a battalion aid station, except that space on board the ship 
was extremely limited. The craft usually could not hold a patient 
more than thirty minutes, and only one of these medical troop carriers 
supported each battalion committed to action. 

On 3 April 1967 representatives of the 44th Medical Brigade, the 
9th Infantry Division Medical Battalion, the U.S. Navy Task Force 
117, and the 436th Medical Detachment (Company Headquarters) 
met aboard the U.S.S. Montrose, the flagship of the Mobile Riverine 
Force, to discuss medical care and evacuation. The participants 
started to work out standard operating procedures for riverine 
aeromedical evacuations. One of the biggest early problems was 
evacuation of soldiers who were wounded on boats. Col. Robert M. 
Hall, MACV Surgeon, advocated a floating litter that one or two 
soldiers could propel through the water to move a casualty to a 
helicopter landing area on the riverbanks. Hoists could also be used to 
lift the patients directly from the assault boats. The Dust Off pilots of 
the 436th tried both these techniques. 

In the summer of 1967 the 45th Medical Company took over from 
the 436th the direct support of the 9th Division. It also supplied field- 
standby aircraft for the division base at Dong Tam. To control these 
aircraft effectively, the division designated a Dust Off control officer 
who monitored radio traffic and regulated the dispatches. The 45th 
continued this mission until 22 December 1968, when the 247th 
Medical Detachment (Helicopter Ambulance) arrived to provide 
evacuation coverage for the Delta. 

By early 1968 Dust Off pilots supporting riverine operations no 
longer had to land on a postage stamp in the middle of the river. 
Because of the long evacuation route and scarcity of hospitals deep in 
the Delta, the 9th Division received permission to make a hospital 
ship out of a self-propelled barracks ship, the U.S.S. Colleton. In 
December 1967 the Colleton sailed to Subic Bay Naval Base in the 
Philippine Islands, where her sick bay was enlarged. One month later 
she rejoined the forces in South Vietnam. Topside the ship had a 
helipad with enough space for one helicopter to land with another 
parked to the side. Navy radio-telephone operators controlled all ap- 


THE SYSTEM MATURES 


59 


proaches to this pad. Down a wide ramp was the triage area with six 
litter stations. On a lower level was the air-conditioned, two table 
surgical suite. The Colleton proved so successful as a hospital ship that 
the division got permission to convert a second vessel. In August 1968 
the U.S.S. Nueces was outfitted as a 37-bed hospital ship, leaving the 
Colleton with the surgical mission. 

Dak To 

Toward the end of 1967, U.S. forces in II Corps Zone fought a 
series of battles that in retrospect seem to be little more than a prelude 
to the great Communist offensive in the spring of 1968. But one of 
them, the battle around Dak To in the Central Highlands, presented 
the Dust Off pilots and unit commanders with several new problems: 
coordinating medical evacuations for a rapidly expanding number of 
allied combat units, arranging for backhauls for the heavy casualties 
that often swamped the nearby 71st Evacuation Hospital at Pleiku, 
and coping with field pickups in rugged terrain concealed by high, 
triple-canopy jungle. 

In August and September 1967 enemy operations in Pleiku Prov¬ 
ince had dwindled. The 4th U.S. Infantry Division in the area had ex¬ 
perienced only scattered contacts with the enemy since July, an ab¬ 
normally long lull in the fighting. But in October intelligence had 
detected large and unusual troop movements near the triborder 
region, west of the Special Forces camp at Dak To in Kontum Prov¬ 
ince, to the north of Pleiku Province. The terrain in this southwest 
portion of Kontum Province is steep, rocky, and covered with heavy 
bamboo and jungle. Only one second class road. Route 512, extended 
into this area, and at Fire Support Base Dak To II it became a single¬ 
lane, loose-surface trail. Dak To, a small town thirty-seven kilometers 
up National Highway 14 from Kontum, housed South Vietnamese 
CIDG forces and their U.S. advisers. Late in October the Special 
Forces troops were constructing a new base nineteen kilometers west 
of Dak To along Route 512; a battalion of the 4th Infantry Division 
furnished screening security. When alerted of the enemy movement, 
the 4th Division commander, Maj. Gen. William R. Peers, quickly 
arranged to have his screening battalion reinforced by the 173d Air¬ 
borne Brigade. He also sent a 4th Infantry brigade headquarters and 
a second battalion to the area. 

In early November North Vietnamese soldiers launched mass at¬ 
tacks on these forces, who retaliating strongly, were further reinforced 
by the 1st Brigade, 1st Cavalry Division. While trying to disengage 
and withdraw, the enemy committed the 174th North Vietnamese Regi¬ 
ment, a reserve unit, to cover their retreat. This resulted in a bloody 
fight for Hill 875, which the American forces assaulted for four days 


369-454 0 -82 - 8 


60 DUST off: army AEROMEDICAL evacuation in VIETNAM 

before taking it. By the end of the fighting in the Dak To area on 1 
December, the U.S. forces there were supporting six ARVN battalions. 

At the start of the fighting on 1 November, a single Dust Off ship 
from the 283d Medical Detachment evacuated the first casualties 
from the clearing station of the 4th Medical Battalion at Dak To II 
back to the 71st Evacuation Hospital at Pleiku. The radio-telephone 
operator at the clearing station took evacuation requests over the 1st 
Brigade’s tactical net and relayed them to the Dust Off ship. When the 
first casualties from a large fight with the enemy took place on 3 and 
early 4 November, the 283d ship had to call on help from transport 
helicopters, both for field pickups and the trip to Pleiku. The 283d 
also quickly field-sited several Hueys at Dak To from its new home at 
Pleiku Air Force Base. Even the gunships of the 52d Combat Aviation 
Battalion started flying noncritical patients from Dak To back to 
Pleiku at the end of the duty day. When the 173d Airborne entered 
the fighting on 8 November two platoons of the 498th Medical Com¬ 
pany (Helicopter Ambulance), twelve helicopters in all, field-sited at 
Dak To to cover the 173d’s casualties. 

The surgeons in the six operating rooms of the 71st Evacuation 
Hospital often could not handle the large number of casualties. 
Surgical lag time grew dangerously long. On 11, 12, and 21 
November an overflow of casualties forced the evacuation of the less 
seriously wounded to the 67th and 85th Evacuation Hospitals at Qui 
Nhon. The Air Force offered invaluable backhaul service at these 
times. After 21 November the Air Force placed its own casualty staging 
facility at Dak To for evacuation of serious and critical patients to Pleiku. 

The mountainous terrain around Dak To and the 200-foot high, 
triple-canopy jungle made it necessary to use extraordinary methods 
on many of the field pickups. During the first eight days of November 
the 283d Detachment flew fifty-nine hoist missions. But the hoists on¬ 
ly partly solved the problem; many patients in early November had 
wounds at least a day old before a doctor saw them. Nurses, corps- 
men, and physicians had to quickly relearn the techniques of 
debriding wounds grown septic through delayed treatment. After the 
first week in November the ground units began using chain saws and 
plastic explosives to clear landing zones. Even though the plastic ex¬ 
plosives and chain saws reduced the number of hoist missions, just 
one usually put the pilot and his crew in grave danger. During a night 
hoist on 13 November southwest of Dak To, one Dust Off aircraft 
took eighteen hits while at a stationary hover. A night hoist mission 
was undoubtedly the most unnerving kind of evacuation flight. Even 
if enemy resistance was slight, the technical problems of such a mission 
could take a heavy toll on a pilot’s physical and mental well-being. 

The battle for Hill 875 accounted for many of the casualties 
evacuated by Dust Off For sixty hours only a few aircraft could reach 


THE SYSTEM MATURES 


61 


the ground forces. In the middle of that period, Lt. Col. Byron P. 
Howlett, Jr., had four Air Force fighters and four helicopter gunships 
cover his approach to a small landing zone on the hill. He landed 
safely and loaded casualties, but on the way out with five seriously in¬ 
jured soldiers his ship took a hit in the rotor head. The ship struggled 
back to the 173d’s clearing station and could not be flown out. After 
Colonel Howlett left the area, Maj. William R. Hill tried to get into 
the same landing zone but took fourteen hits and had to abort the mis¬ 
sion. The next day the 173d secured the area around the landing zone 
and Dust Off evacuated 160 casualties. All in all, the Dust Off units 
had four aircraft shot up and five crewmen wounded while evacuating 
1,100 patients. The system had proven resourceful enough to solve 
several new and perplexing problems. 

The 54th and the Kelly Tradition 

Pilots in any war consider themselves an elite group, and this was 
no less true for the Dust Off pilots in Vietnam than for the combat 
pilots. The Lafayette Escadrille of American pilots in France in 
World War I had set the pattern — a high life style and the esprit de corps 
possible in a small unit of highly skilled fighting men, in control of the 
most advanced technology. The dramatic entries of Dust Off ships in¬ 
to combat zones, usually unarmed and often unescorted, gave the 
pilots and crews a publicity that only heightened their sense of 
camaraderie. In the Korean War well-defined battle lines had permit¬ 
ted most helicopter medical evacuations to originate behind friendly 
lines. But the frontless nature of the guerrilla war in Vietnam 
demanded a novel marriage of the dash of the combat pilot with the 
often unheralded courage of the Army medical corpsman. 

Maj. Charles L. Kelly was the first Dust Off pilot to exploit fully 
the possibilities of the medical helicopters. Not all Medevac and Dust 
Off pilots who arrived after his death tried to emulate his daring, but 
all fully understood that they could fly few of their missions without a 
good dose of raw courage. No Dust Off unit came closer to combining 
the Kelly tradition and the legacy of the Lafayette Escadrille than the 
54th Medical Detachment (Helicopter Ambulance) stationed at Chu 
Lai, a port city on the southern coast of I Corps Zone. 

In June 1967 the 54th was stationed at Fort Benning, Georgia, 
providing evacuation coverage for its Infantry, Airborne, and Ranger 
Schools. That month when the unit received an alert notice for 
deployment to Southeast Asia, only three of its members were eligible 
to go: Capt. Patrick H. Brady and two enlisted men. As new person¬ 
nel began to filter into the unit, it also received six new UH-lH’s 
straight from the Bell plant. 

Captain Brady, who had flown with Kelly in 1964 and assumed 


62 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


command of Detachment A at Soc Trang after his death, began train¬ 
ing the new pilots. All the new warrant officer pilots came from the 
same flight school class that had graduated 6 June. All but one of their 
names began with “S.” The Army had taken an entire alphabetical 
block out of the class and assigned it to the 54th. After introducing the 
pilots to the aircraft, Brady stressed his technique of tactical flying, 
which involved close analysis of the terrain to find the best approach 
to a hot landing zone. 

The advance party, led by Brady, flew over to Vietnam early in 
August and reported to the 44th Medical Brigade at Long Binh. He 
was instructed to take his unit to Chu Lai in I Corps Zone. Flying 
north along the coast, they stopped off for a night to visit friends at the 
498th Medical Company at Qui Nhon. Maj. Paul A. Bloomquist, 
commander, was not able to add much to the scanty information the 
54th already had about its new assignment. At Chu Lai, Brady went 
to the 2d Surgical Hospital, which offered him a plot of land near the 
airfield. Most of the personnel and equipment of the 54th flew over on 
a USAF C-141 and arrived on 23 August. The 44th Medical Brigade 
assigned the 54th to the 55th Medical Group, which, in turn, gave 
operational control of the 54th to the 498th Medical Company. 

As soon as all the men arrived, everyone pitched in to build a liv¬ 
ing area. Thanks to their industry and Brady’s determination, they 
soon had a home. They obtained the first flush toilets in the Chu Lai 
area, even before the commanding general. Each man had a private 
room. They also built hot-water showers, a necessity in an area 
covered with red clay and dust. The enlisted men had a two-story 
rock-faced billet, which also contained the unit’s music room, steam 
room, bar, and air-conditioned library, stocked by Captain Brady 
with 5,000 volumes. Outside was a pond, lined with palm trees and 
spanned by a wooden bridge. The unit’s pets included several ducks, 
Gertrude the goose. Super Oink the pig, and Frances the monkey. 
Most of the men found themselves bicycles, and when Frances fell off 
one of them and hurt herself, the nearby 2d Surgical Hospital gladly 
restored her to health. For rest and relaxation, most of the men liked 
to go out to an island named Cu Lao Re, an extinct volcano that 
Navy men also used for scuba diving, fishing, and sunning. 

When the U.S.N.S. Card, carrying the unit’s helicopters and spare 
parts, arrived at Vung Tau, a port at the mouth of the Saigon River, 
on 24 September, the 54th’s commander, Maj. Robert D. 
McWilliam, sent crews down to accept them, inspect them, and ferry 
them back to Chu Lai. The next day the unit became totally opera¬ 
tional. To stagger personnel departure dates and provide some per¬ 
sonnel continuity, it was customary to infuse a new unit in Vietnam 
with men who had already been in the country a few months, shifting 
some of the new men to older units. But the 54th resisted attempts to 


THE SYSTEM MATURES 


63 


break up its original team. McWilliam and Brady knew the value of 
unit cohesion. They also instilled in their pilots the attitude that every 
mission, day or night, was urgent and should be treated as such, 
whether the patient was a papa-san with worms or an American 
soldier bleeding to death. 

One day of the unit’s work impressed all the people in the Chu Lai 
area. Friday, 29 September, became embedded in the memories of 
the 54th as “Black Friday.” The day started out as usual —the crews 
eating breakfast, preflighting their ships, and then flying a couple of 
routine missions. But by that evening all six of the unit’s aircraft had 
been subjected to intense enemy fire at various landing zones, and all 
had been damaged. Three crewmen had been wounded. This was a 
true baptism of fire for the fledgling unit. That night most of them 
looked out at the twelve months that stretched before them, and 
thought that it would be a very long year. In fact, twenty-two of the 
crewmen would be wounded during that year, but none killed. 

Dust Off Wins Its First Medal of Honor 

As Dust Off flew more and more missions the bravery of its pilots 
and crews became evident to all who fought in South Vietnam. While 
each of these pilots returned from a Dust Off mission something of a 
hero, some pilots distinguished themselves more than others. On the 
night of 5 January 1968 a South Vietnamese reconnaissance patrol 
left its camp in a heavily forested valley surrounded by mountains 
west of Chu Lai. An enemy force soon hit the patrol and inflicted 
several casualties. When the patrol limped back into camp with its 
wounded, Sgt. Robert E. Cashon, the senior Special Forces medical 
specialist at the base, tended to two critical patients and radioed his 
headquarters for a Dust Off ship. Soon the aircraft arrived overhead 
and tried several times to land in the camp. The pilot finally had to 
leave because fog and darkness obscured the ground. The monsoon 
season had enshrouded the mountains in soft, marshmallow clouds 
and fog several hundred feet thick. The clouds and fog extended east 
all the way to the flatlands between the mountain chain and the South 
China Sea. 

Dawn brought little improvement in the weather. Visibility and 
ceiling were still zero. The next crew who tried to reach the camp, at 
0700, also failed, even though they had been flying in that area for 
five months. True to the Kelly legacy of unhesitating service, Patrick 
H. Brady, now a major, and his crew of Dust Off 55 now volunteered 
for the mission into the fog-wrapped mountains. 

They flew from Chu Lai to the mountains at low leveLjust under 
the cloud base, then turned northward to Phu Tho where a trail 
wound westward through the mountains to the reconnaissance camp. 


64 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


The fog grew so thick that none of the crew would even see the rotor 
tips of the helicopter. To improve the visibility, Brady lowered his side 
window and tilted his ship sideways at a sharp angle from the ground. 
The rotor blades blew enough fog away for him to barely make out the 
trail below the ship. Hovering slowly along the trail and occasionally 
drawing startled enemy fire, Dust Off 55 finally reached the valley 
and the camp. The visibility there was so poor that the ship complete¬ 
ly missed the camp’s landing zone and set down in a smaller clearing 
less than twenty meters square between the inner and outer defensive 
wires of the camp. The outpost had earlier taken mortar rounds and 
was still under sniper fire. Sergeant Cashon later said that the landing 
area would have been hazardous even in good weather. But Dust Off 
55 loaded up, climbed out through the soup, and flew the two critical 
patients and four others to surgical care. 

Brady’s sweat from the first mission was hardly dry when another 
request chattered in over the 54th’s radio. In the late afternoon of the 
day before, a company of the 198th Light Infantry Brigade, 23d In¬ 
fantry Division, operating on the floor of the Hiep Due Valley, came 
under a concerted attack by six companies of the 2d North Vietnamese 
Division. For nine hours from their well-fortified positions in the sur¬ 
rounding hills, the North Vietnamese rained mortars and rockets on 
the Americans. The enemy had covered the likely flight paths into the 
area with 12.7-mm. antiaircraft guns. Early in the assault they had 
shot down two American gunships. Difficult communications and the 
nearness of the enemy on the night of the fifth had made a Dust Off 
mission impossible, even though the enemy had inflicted heavy 
casualties on the Americans. By dawn the company had sixty wound¬ 
ed on its hands. 

On the morning of the sixth, a Dust Off pilot WOl Charles D. 
Schenck, starting from fire support base West overlooking the valley, 
tried to fly a medical team out to the company and bring some of the 
wounded back. But the vertigo he suffered from the zero visibility 
forced him to abort. Shortly after he returned and told Dust Off 
Operations Control of his failure. Major Brady and Dust Off 55 
began to prepare for flight. Brady, who knew the Hiep Due Valley, 
listened to Schenck and the other pilots who had tried to reach the 
stranded company. Then he loaded a medical team in his ship, 
cranked the engine, and took off. Several miles from the battle area he 
found a hole in the soupy clouds through which he descended to 
treetop level. After twenty long minutes of low-level flight. Dust Off 
55 neared the stricken company. Brady’s surprise approach and the 
poor visibility threw off the enemy’s aim; the helicopter landed safely. 

Once on the ground the medical team quickly found and loaded 
the most seriously wounded. Brady made an instrument takeoff 
through the clouds, flew to fire base West, and delivered his casualties 


THE SYSTEM MATURES 


65 


to the aid station. He then briefed three other crews on how he would 
execute his next trip into the area. The three ships tried to follow 
Brady in, but thick fog and enemy fire made them all climb out and 
return to West. Brady kept going, landed, picked up a load of wound¬ 
ed, and flew them out to West. Twice more he hovered down the trail 
and brought out wounded. Although the three other ships again tried 
to emulate his technique, none could make it all the way. Brady and 
his crew evacuated eighteen litter and twenty-one ambulatory pa¬ 
tients on those four trips. Nine of the soldiers certainly would not have 
survived the hours which passed before the fog lifted. 

As soon as Dust Off 55 refueled, Brady was sent on an urgent mis¬ 
sion to evacuate the U.S. soldiers from a unit surrounded by the 
enemy twenty-six kilometers southeast of Chu Lai. Machine guns 
swept the landing zone as the North Vietnamese tried to wipe out the 
remaining American troops. Brady tried another surprise tactic. He 
low-leveled to the area, dropped in, turned his tail boom toward the 
heaviest fire to protect his cockpit, and hovered backward toward the 
pinned soldiers. The ship took rounds going in and once it was on the 
ground the fire intensified. For fear of being wounded or killed 
themselves, the friendly forces would not rise up and help load the 
casualties. Seeing this, Brady took off and circled the area until the 
ground troops radioed him in a second time. As he repeated his 
backward hover, the enemy tried once more to destroy the aircraft. 
But this time the ground troops loaded their comrades, who were soon 
in the rooms of the 27th Surgical Hospital at Chu Lai. 

After four hours of flying that Saturday morning, Brady had to 
change his aircraft and find a relief copilot. A few hours earlier a pla¬ 
toon of the 198th Light Infantry Brigade on a patrol southeast of Chu 
Lai had walked into a carefully planned ambush. Automatic weapons 
and pressure-detonated mines devastated the platoon, killing six 
soldiers outright and wounding all the others. The platoon leader 
called for Dust Off. A helicopter soon landed, but took off quickly 
when a mine detonated close by, killing two more soldiers of the 198th 
who were crossing the minefield to aid the wounded. 

Hearing this, Brady radioed that he would try the mission. The 
commander of the first aircraft suggested that Brady wait until the 
enemy broke contact. But Brady immediately flew out and landed on 
the minefield. Most of the casualties lay scattered around the area 
where they had fallen. Brady’s crew chief and medical corpsman 
hustled the wounded onto the ship, disregarding the enemy fire and 
mines. As they neared the ship with one soldier, a mine detonated on¬ 
ly five meters away, hurling the men into the air and perforating the 
aircraft with shrapnel holes. Both crewmen stood up, shaken by the 
concussion but otherwise unhurt, and placed the casualty on board. 
With a full load Brady flew out to the nearest hospital. 


66 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


When he returned to the Dust Off pad at Chu Lai and delivered 
his patients, he again traded his ship for another. He flew two more 
urgent missions before he ended his day of glory well after dark. He 
had flown three aircraft and evacuated fifty-one wounded soldiers. 
For this day’s work he was awarded the Medal of Honor. 

Dust Off in the Saddle 

As this buildup phase of the war ended in early 1968, U.S. troop 
strength in South Vietnam approached a half million uniformed men 
and women. By late 1967 the medical support required for this large 
military force and the supplementary medical support furnished to 
the South Vietnamese were fairly well-organized. Hospitals were ra¬ 
tionally dispersed, and they usually performed their mission com¬ 
petently. Most of the air evacuation units that would serve in Viet¬ 
nam were already there. Air crew casualties, while certainly disturb¬ 
ing, were not alarmingly high. The air ambulance helicopter had 
never been better equipped for its work. The advent of the Lycoming 
L-13 helicopter engine in the UH-lH’s had eliminated the problem 
of the underpowered aircraft that would not always perform. The 
enemy’s antiaircraft threat was still primitive, consisting mainly of 
eye-sighted small arms. The Army’s new radios had smoothed com¬ 
munication difficulties considerably. And the hoist, while creating 
new dangers, enabled the Dust Off pilots and crews to extract 
casualties who otherwise would have languished hours before 
reaching a hospital. 

Most important of all, the Kelly tradition had survived in full 
force in the 54th Detachment, and the pilots of the other detachments, 
the companies, and the divisional platoons often dared to enter land¬ 
ing zones that they suspected were dangerous. The courage of these 
pilots, far more than prescribed procedures and rigidly defined chan¬ 
nels, had made the Dust Off system an object of reverence in the ever- 
shifting battlefields of Vietnam. 


CHAPTER IV 


The Pilot At Work 

From 1965 to 1970 the U.S. Army in Vietnam perfected tech¬ 
niques of aeromedical evacuation that helped save the lives of hun¬ 
dreds of thousands of Americans and Vietnamese, both friend and 
foe, both soldiers and civilians. Many of the techniques had been 
worked out in the early years of U.S. involvement in Vietnam, from 
1962 to 1965, when only the 57th and 82d Medical Detachments of¬ 
fered air ambulance service to the U.S. and South Vietnamese Ar¬ 
mies. After the buildup of American forces began in 1965, the 
helicopters, procedures, and rescue equipment were improved and 
sometimes tested on mass casualties. Refinements of the system were 
made after the Tet offensive in 1968, and Army air ambulances 
evacuated more patients in 1969 than in any other year of the war. 
Then, as it began to withdraw its forces from Vietnam, the U.S. Ar¬ 
my set up a training program to pass on its skills in air ambulance 
work to the South Vietnamese Army and Air Force. Assisting the 
development of the helicopters and rescue equipment and acquiring 
the skills needed to use them demanded exceptional imagination, 
dedication, and compassion, both of U.S. Army medical personnel 
and the South Vietnamese who learned from them. 

The UH-1 Iroquois CHuey”) 

When it entered the Vietnam War the U.S. Army lacked a 
satisfactory aircraft for medical evacuation. As early as 1953 the Avia¬ 
tion Section of the Surgeon General’s Office had specified the 
desirable characteristics of an Army air ambulance. It was to be 
highly maneuverable for use in combat zones, of low profile, and 
capable of landing in a small area. It was to carry a crew of four and at 
least four litter patients, yet be easily loaded with litters by just two 
people. It had to be able to hover with a full patient load even in high 
altitude areas, and to cruise at least ninety knots per hour fully loaded. 
But in 1962 the Army’s basic utility aircraft, the UH-IB made by Bell 
Aircraft Corporation, still did not meet these standards. It was, however, 
a small craft with a low profile, and the Army’s MSG pilots could console 
themselves with the fact that the Huey was a far better air am¬ 
bulance than the one their predecessors had flown in the Korean War. 
It had nearly twice the speed and endurance of the H-13 Sioux, and it 


68 DUST off: army AEROMEDICAL evacuation in VIETNAM 

could carry patients inside the aircraft, allowing a medical corpsman 
to administer in-flight treatment. 

In almost all other respects it was less than perfect. One of its ma¬ 
jor problems was the comparatively low power of the engine. The 
critical factor in planning all helicopter flights with heavy cargoes is 
what pilots know as “density altitude”—the effective height above sea 
level computed on the basis of the actual altitude and the air 
temperature. The warmer the air, the less its resistance to the rotor 
blades and the less lift they produce. Because of its lack of fixed wings, 
which permit a powerless glide, a helicopter whose engine quits or 
fails to produce adequate power at a high density altitude can easily 
crash. Given enough forward airspeed and height, most helicopters, 
including all the Huey models, can drop to the earth and still land if 
the power fails, using the limited lift produced by the freely-spinning 
rotor blades. But this maneuver, called an autorotation, is virtually 
impossible to execute in a low-level, hovering helicopter. A writer for 
the Marine Corps suggests that this explains “...why, in generality, 
airplane pilots are open, clear-eyed, buoyant extroverts and 
helicopter pilots are brooders, introspective anticipators of trouble.” 

Although the A- and B-model Huey engine often lacked enough 
power to work in the heat and high altitudes of South Vietnam, it was 
much stronger than earlier Army helicopter engines. A great advance 
in helicopter propulsion had come in the 1950s with the adaptation of 
the gas turbine engine to helicopter flight. The piston-drive engines 
used in Korea and on the Army’s UH-34 utility helicopters in the 
1950s and early 1960s had produced only one horsepower for each 
three pounds of engine weight. The gas turbine engines installed on 
the UH-1 Hueys, which the Army first accepted in 1961, had a much 
more favorable efficiency ratio. This permitted the construction of 
small, low-profile aircraft that was still large enough to carry a crew of 
four and three litter patients against the back wall of the cabin. But 
the high density altitudes encountered in II Corps Zone in Vietnam 
meant that the UH-1 A and UH-IB with a full crew —pilot, aircraft 
commander, crew chief, and medical corpsman —often could carry no 
more than one or two patients at a time. 

In the early 1960s, shortly after the first U.S. Army helicopters 
were sent to South Vietnam, the Army began to use an improved ver¬ 
sion of the UH-IB: the UH-ID, which had a longer body with a 
cabin that could hold six litter patients or nine ambulatory patients. 
The longer rotor blade on the UH-ID gave it more lifting power, but 
high density altitudes in the northern two corps zones, where U.S. 
troops did most of their fighting, still prevented Dust Off pilots from 
making full use of the aircraft’s carrying capacity. Finally in 1967 the 
commander of the 4th Infantry Division registered a complaint about 
his aeromedical evacuation support. 


THE PILOT AT WORK 


69 


The 498th Medical Company, which served this area, had per¬ 
formed 100 hoist missions from July 1966 to February 1967 but had 
aborted 12 of them, 3 because of mechanical failures of the hoist and 9 
because of the inability of the helicopter to hover. In March 1967 at 
Nha Trang, the staff of I Field Force, Vietnam, held a conference of 
various personnel involved in aeromedical evacuation in northern 
Vietnam. The conference noted the low engine power of the 
UH-lD’s working in the Central Highlands, especially of those with 
the 498th Medical Company and the Air Ambulance Platoon of the 
1st Cavalry. 

In July 1967 the arrival at Long Binh of the 45th Medical Com¬ 
pany (Air Ambulance), equipped with new, powerful UH-lH’s 
marked the end to the Huey’s propulsion problem. Headquarters, I 
Field Force, Vietnam, soon conducted a test of the engine power of 
the UH-ID, the Kaman HH-43 “Husky,” and the new UH-IH with 
an Avco Corporation T-53-L-13 engine. The study showed that the 
maximum load of an aircraft hovering more than about twenty feet 
above the ground (out of ground effect) on a normal 95° F. day in the 
western Highlands was 184 pounds for the UH-ID with an L-11 
engine, 380 pounds for the Husky, and 1,063 pounds for the UH-IH 
with an L-13 engine. This meant that on such a day the UH-ID 
could not perform a hoist mission; the Husky could pull at most two 
patients; and the UH-IH could pull five hoist patients. The L-13, 
rated at 27 percent more horsepower than the L-11, consumed 9 per¬ 
cent less fuel. The other air ambulance units in Vietnam obviously 
had to start using the UH-IH. 

On 21 January 1968 the last UH-ID air ambulance in the U.S. 
Army, Vietnam, left the 57th Medical Department and became a 
troop transport in the 173d Assault Helicopter Battalion at Lai Khe. 
Now the entire fleet of air ambulances had powerful UH-lH’s, solv¬ 
ing many of the problems caused by high density altitudes, hoist mis¬ 
sions, and heavy loads. Also, unlike most of the UH-lD’s, the 
UH-lH’s were fully instrumented for flight at night and in poor 
weather. They proved to be rugged machines, needing comparatively 
little time for maintenance and repairs. Like the earlier models, the 
H-models came with skids rather than wheels, to permit landing on 
marshy or rough terrain. The UH-lH’s only important departure 
from the 1953 specifications of the Aviation Section was its inability to 
sustain flight if part or all of one rotor blade were missing. It was a 
single-engine craft with only two main rotor blades; the loss of all or 
part of one main blade would create an untenable imbalance in the 
propulsion system. And the Army version of the UH-IH had a flam¬ 
mable magnesium-aluminum alloy hull. Still, in most ways the 
UH-IH proved to be an ideal vehicle for combat medical evacuation. 


70 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


The Hoist 

The terrain in Vietnam —a mixture of mountains, marshy plains, 
and jungles —dictated the use of the helicopter for almost all 
transport. The changes in the design of the UH-1 Iroquois and its 
equipment during the Vietnam conflict stemmed largely from the 
problems presented by that difficult terrain. Early in the war the 57th 
Detachment recognized the need for some means of getting troops up 
to a helicopter hovering above ground obstacles that prevented a 
landing. The 57th sorely needed such a device for use in heavily 
forested areas, where until then medical evacuations had required 
moving the wounded and sick to an open area or cutting a pickup 
zone out of the jungle. During three military operations against the 
Viet Cong in War Zone D from November 1962 to March 1963, the 
South Vietnamese Army and their American advisers became acutely 
aware of this problem. The thick jungles in the area made resupply 
and medical evacuation by helicopter extremely difficult. Some of the 
South Vietnamese units carried their wounded for as long as four 
days before finding a suitable landing area for the UH-lA’s. The 
problem was most acute when soldiers were wounded in the first few 
days of an operation, before reaching their first objective. This forced 
the ground commander either to delay his mission while sidetracking 
to a pickup zone, to carry the wounded with the assault column, or to 
leave the casualties behind with a few healthy soldiers for protection. 

In attacking this problem, the armed services and their civilian 
contractors devised two fanciful and ultimately unsuccessful devices. 
Each entailed loading the helicopter while it hovered above the obstacles 
that surrounded the wounded below. The XVIII Airborne Corps at Fort 
Bragg devised a collapsible box-like platform that the ground troops were 
to strap to the upper reaches of a large tree. After the helicopter had 
dropped the platform to the soldiers on the ground, they would climb the 
tree, attach the platform, bring up the wounded, and wait while the 
helicopter moved into a hover just above the platform and the crew ex¬ 
tended a rigid ladder four feet below the aircraft skids. Supplies would 
then be moved down and wounded or sick soldiers up the ladder. Tests 
revealed the absurdity of the device: wounded troops could hardly be 
moved to the top of a tree with ease, and the platform itself proved dif¬ 
ficult to secure in the upper reaches of dense, multi-layered jungle. 

A variation on this theme, the “Jungle Canopy Platform System,” 
consisted of two stainless steel nets and a large platform. From the 
hovering helicopter the crew would unroll the nets onto the top of the 
jungle canopy, so that they intersected at midpoint; then the crew 
would lower the platform onto the intersection of the nets and signal 
the pilots to land on it. Troops and supplies could then move to and 
from the aircraft. The 1st Cavalry Division tested the device in Viet- 


THE PILOT AT WORK 


71 


nam during noncombat operations; actual combat reports on it could 
not be obtained because no unit would use it under those conditions. 
Without the platform the nets worked well for deploying troops but 
proved unreliable for other uses, such as medical evacuation. The test 
report concluded: “Based on commanders’ reluctance to use the 
system, there appears to be no current requirement for the Jungle 
Canopy Platform System.” 

Despite these two failures, the Army did develop a piece of sup¬ 
plemental equipment for the Huey that both advanced the art of 
medical evacuation and placed extraordinary new demands on the air 
ambulance pilots: the personnel rescue hoist. The hoist was a winch 
mounted on a support that was anchored to the floor and roof of the 
helicopter cabin, usually just inside the right side door behind the 
pilot’s seat. When the door was open, the hoist could be rotated on its 
support to position its cable and pulleys outside the aircraft, clear of 
the skids, so that the cable could be lowered to and raised from the 
ground. After a UH-1 was outfitted with the necessary electrical 
system, the aircraft crew could quickly install or remove the hoist. On 
a hoist mission, while the aircraft hovered, the medical corpsman or 
crew chief would use the hoist cable to lower any one of several types 
of litters or harnesses to casualties below. If a wounded soldier and his 
comrades were unfamiliar with the harness or litter, the crew chief 
would sometimes lower a medical corpsman with the device; then the 
hoist would raise both the medic and the casualty to the helicopter. 
The standard hoist eventually installed on the UH-ID/H could lift 
up to 600 pounds on one load and could lower a harness or litter about 
250 feet below the aircraft. 

As early as November 1962 the Surgeon General’s Office had said 
that the Army’s air ambulances needed a hoisting device. Under fur¬ 
ther pressure from the 57th Medical Detachment, the Surgeon 
General had the Army contract with Bell Aircraft Corporation and 
the Breeze Corporation for the personnel rescue hoist. The U.S. 
Army Medical Test and Evaluation Activity experimented with the 
new hoist at Fort Sam Houston in April and May 1965 and 
recommended that it be adopted with minor modifications. 

In May 1966 the first hoists began arriving in Vietnam, and on 17 
May, Capt. Donald Retzlaff of the 1st Platoon, 498th Medical Com¬ 
pany, at Nha Trang, flew the first hoist mission in Vietnam. But 
within a week the hoist proved unreliable, prone to jam and break 
during a lift. After being grounded for two months for repairs and 
redesigning, the hoist, now modified, went back into service. It con¬ 
tinued to be a maintenance problem for the rest of the war, but it 
functioned well enough to save several thousand lives. 

Although air ambulance pilots began to use the hoist in Vietnam 
in August 1966, their commanders soon complained about the ex- 


369-454 0 - 82-6 


72 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


traordinary hazards it brought to their work. The UH-ID was 
already burdened with a heavy single sideband (high frequency) 
radio and a navigation system; the extra weight of the hoist com¬ 
pounded the problem of the underpowered L-11 engine. Since the 
crew chief worked on the same side of the aircraft as the hoist, the 
helicopter was heavily overweighted on one side, and a strong gust of 
wind from the other side could endanger the craft’s stability. The 
operation also demanded great strength and concentration of the 
pilots, especially if winds were gusting or if trees or the enemy forced 
a downwind or crosswind hover. The danger of mechanical troubles 
was obvious: almost by definition no emergency landing site was 
nearby, and even if it were, the ship usually was hovering at a height 
that precluded an autorotational touchdown in an emergency. 

Adding to the tenseness of such a mission, the crews knew that the 
most vulnerable target in the war was a helicopter at a high hover. 
The precautions that had to be taken against sudden enemy fire 
proved especially taxing on the pilots. The men in the rear of the air¬ 
craft cabin would set the intercom switches on their helmets to “hot 
mike,” allowing them to communicate with the rest of the crew 
without depressing their microphone buttons. While working the 
hoist or putting down suppressive fire the crew chief and medical 
corpman could keep the pilot informed of his nearness to trees or 
other hazards. While listening to this chatter, the pilots also had to be 
in radio contact with the people on the ground. In December 1966 an 
officer of the 1st Cavalry Division in the Central Highlands complained: 

We are very dissatisfied with the hoist and any of its associated equipment. 
Mainly because we’ve been shot up pretty badly twice during Operation 
Thayer while in position for hoist extraction. Fortunately so far we’ve had 
only two crew members slightly wounded. On both occasions the VC 
haven’t fired a shot in the last ten to thirty minutes. Then, just as the hook 
enters the pickup site, he cuts loose. He is so close to our troops on the 
ground ... the armed escort ships can’t fire for fear of hitting our own troops. 

The hook on the end of the hoist cable could accept several types 
of rescue devices. A traditional rescue harness worked well for pulling 
up lightly injured soldiers, but it proved difficult and often impossible 
to lower through the thick upper vegetation of Vietnam’s forests and 
jungles. Seriously wounded soldiers usually had to be placed in the 
rigid wire Stokes litters and raised horizontally; but this too caused 
problems in thick jungles and forests. For the lightly wounded and the 
less seriously wounded, the air ambulances almost always used a 
device designed early in the war—a collapsible seat called the forest 
penetrator, which could easily be lowered through dense jungle 
canopy. Developed by the Kaman Corporation, the penetrator 
weighed twenty pounds, and had three small, paddle-like seats that 


THE PILOT AT WORK 


73 


could be rotated upwards to lock into place against the sides of the 
penetrator’s narrow, three-foot long, bullet-shaped body. Once to the 
ground, the seats could be lowered and the wounded strapped on with 
chest belts. Although the version accepted by the Army had no protec¬ 
tion for the casualty’s head as he was raised up through the foliage, 
this seldom proved a problem. The first eight forest penetrators arrived 
in Vietnam in mid-June 1966, but extensive testing of the device with the 
new hoists was delayed until September and October. Medical person¬ 
nel then found the device satisfactory and it became the normal 
means of lifting a conscious casualty. Unconscious soldiers were often 
lifted head up, in a device known as the semi-rigid litter: a flexible 
canvas jacket with a lining of wood straps and a rigid head cover. 

Even when the penetrator was used, a hoist mission took con¬ 
siderably longer than usual at the pickup zone. Pilots flying the first 
missions found their ships often subject to accurate enemy fire. On 1 
November 1966 the 283d Detachment at Tan Son Nhut got a request 
from a ground unit not far outside Saigon’s noise and bustle. The unit 
had casualties deep under the jungle and needed a hoist to get them 
out. In the 283d, Capt. James E. Lombard and 1st Lt. Melvin J. 
Ruiz had the only ship fitted with a hoist. 

As soon as they left the ground at Tan Son Nhut they radioed the 
ground unit and asked whether it had any gunships standing by or 
had asked for any. The unit answered that it had requested them but 
had no idea how long they would take getting there. Three minutes 
later Lombard and Ruiz arrived over the pickup site. Lombard told 
the troops on the ground that he would have to have gunship support 
before he could land. He radioed a gunship unit at Bien Hoa, a five 
minute flight away, and asked them to launch a team to cover his mis¬ 
sion. He was told there would be a thirty minute delay. The ground 
unit commander than started a sales pitch: there had been one sniper, 
but they had got him, the area was secure now, they had two critically 
wounded. Lombard agreed to come down. 

The ground unit popped a smoke grenade, and the Dust Off ship 
came to a hover over the spot where wisps of colored smoke drifted up 
through the trees. The crew chief played out the hoist cable. The 
forest penetrator was ten feet below the skids when an automatic 
weapon opened up on the helicopter from the right side. Bullets whined 
and zinged through the aircraft, and the pilot’s warning lights lit up 
like a Christmas tree. Lombard broke off the hover. The hydraulics 
were gone and the crew heard crunching and grumbling sounds from 
the transmission. They headed east toward a safe haven at Di An, a 
four minute flight away. Suddenly the engine quit. Luckily within 
reach of their glide path lay an open area to which they shot an 
autorotation. With the controls only half working, Lombard had to 
make a running landing, skidding along the ground. The ship tipped 


74 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


well forward on its skids then rocked back to a stop. The engine com¬ 
partment was on fire. The crew got out as fast as possible, the pilots 
squeezing between the door frame and their seats’ sliding armor side 
plates, which were locked in the forward position. They started to run 
from the aircraft when they realized that their rifles and ammunition 
were still inside. The medical corpsman dashed back inside, grabbed 
the rifles and bandoliers, jumped back out, and distributed the arms. 

They looked around and decided that they had overflown the 
enemy, who now separated them from the friendly unit with the 
casualties. Rather than head into a possible ambush, they started 
toward a knoll in the direction of Long Binh. Unknown to them, 
another platoon of the friendly company was out on a sweep headed 
in their direction. On the ground the crew was completely out of their 
environment. Their loaded MiG’s cocked on automatic, they were 
ready to shoot the first blade of grass that moved. Suddenly they 
heard the thump, thump, thump of troops running toward them. 
They stopped, waited, then saw U.S. troops coming at them through 
the bush. 

They all went back to the landing zone, where they set up a small 
defensive perimeter. Later that afternoon, the platoon that had called 
in the request cut its way out of the jungle and joined them. Its two 
wounded had died on the way out. The company commander radioed 
Di An and asked its mortars to start laying a protective barrage 
around the perimeter. The first salvo landed on the company and 
wounded many of them. The commander radioed for another Dust 
Off. Two hours later as dusk approached, a Dust Off ship from the 
254th Detachment flew in with a gunship escort. In several trips it 
evacuated nineteen wounded soldiers, the two dead, and the crew 
from the 283d. Lombard and Ruiz had flown the first of many hoist 
missions that resulted in the downing of an air ambulance. But the 

hoist had clearly added a new dimension to utility of the helicopter in 
Vietnam. Despite the new danger it brought to their work, the air am¬ 
bulance crews responded with courage and dedication. 

Evacuation Missions 

Air ambulances received their missions either aloft in the aircraft, 
at the ambulance base, or at a standby base, usually near or at a bat¬ 
talion or brigade headquarters. The coverage given by the am¬ 
bulances was either area support (to all allied units in a defined area) 
or direct support (to a particular unit involved in an operation). 
Direct support, in effect, dedicated the aircraft to a particular combat 
unit, and it usually relieved the aircraft commander of the need to 
receive mission authorization from his operations officer. Both air 
ambulances organic to combat units and nonorganic aircraft flew 
direct support missions. 


THE PILOT AT WORK 


75 


Most air ambulance missions, however, originated during area 
support. An American or allied patrol would take casualties, usually 
in daylight, from enemy sniper fire, mines, or other antipersonnel 
devices. The patrol commander and medical corpsman would decide 
whether the casualties needed to be evacuated by helicopter. If a Dust 
Off or Medevac aircraft were needed, the patrol would, if its radio 
were powerful enough, send its request directly to the air ambulances 
or their operations control. If this were not possible, the patrol would 
use its tactical radio frequency to send the request back to its battalion 
headquarters. Whichever method was used, the request had to con¬ 
tain much information: coordinates of the pickup site, the number 
and types (litter or ambulatory) of patients, the nature and 
seriousness of the wounds or illness, the tactical radio frequency and 
call sign of the unit with the patients, any need for special equipment 
(such as the hoist, whole blood, or oxygen), the nationality of the pa¬ 
tients, visual features of the pickup zone (including any smoke, lights, 
or flares to be used by the ground unit), the tactical security of the 
pickup zone, and any weather or terrain hazards. The first four 
elements were critical: with them a mission could be flown; without 
them no air ambulance could guarantee a response. 

Two elements of any request were open to considerable inter¬ 
pretation by the ground commander and his medical corpsmen: the 
seriousness of the medical problem and the security of the pickup 
zone. Three levels of patient classification were used: urgent, priori¬ 
ty, and routine. Urgent patients were those in imminent danger of 
loss of life or limb; they demanded an immediate response from any 
available air ambulance. Priority patients were those with serious but 
not critical wounds or illness; they could expect up to a four-hour 
wait. In theory a medical corpsman had to ignore the suffering of a 
patient in determining his classification: a soldier in great pain, with a 
foot mangled by a mine, warranted, if his bleeding were stanched, only a 
priority rating. In practice, despite the considerable efforts of 
aeromedical personnel, any patient bleeding or in great pain usually 
received an urgent classification. Just as many patients were 
overclassified, many dangerous pickup zones were reported as secure, 
and this too was understandable. Although some air ambulance units 
tried to fight the policy, Army doctrine limited the ground unit’s 
responsibility in reporting on a pickup zone: if the unit’s soldiers could 
safely stand up to load the casualties, the pickup zone could be 
reported as secure. So the air ambulance crew could never be sure 
that the airspace more than ten feet above the ground would be safe. 
It was highly important for an aircraft commander approaching a 
pickup zone to establish radio contact with the ground unit and learn 
as much as possible about enemy forces near the zone. 


76 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


If the ground unit with the patient had to send its evacuation re¬ 
quest through its battalion headquarters, the headquarters would 
make sure the request had all essential information and then either 
send it directly over the established air ambulance radio frequency or, 
if it lacked the proper radios, forward it to brigade headquarters, who 
almost always could communicate directly with the air ambulance 
operations officer. 

Once an air ambulance received an urgent request, its personnel 
dropped any priority or routine tasks and headed toward the pickup 
zone. The aircraft commander performed a variety of duties of such a 
mission. He supervised the work of the pilot and two crewmen, and 
worked as copilot and navigator. En route he monitored both the tactical 
and air ambulance frequencies, and talked to the ground unit with the 
patient. Once over the pickup zone, he surveyed the area and decided 
whether to make the pickup, with due regard to urgency, security, 
weather, and terrain. If he decided to land he had to choose directions 
and angles of approach and takeoff. If problems developed at the 
pickup zone he had to decide whether to abort the mission. Once the 
pickup was made, he had to choose and receive confirmation on the 
suitability of a destination with medical facilities. He usually sat in the 
left front seat, leaving the right seat to the pilot, who needed a view of 
the hoist on the side and the flight control advantages of the right side 
position. Usually the commander left the en route flying to the pilot, 
but sometimes flew the final approach and the takeoff, especially at an 
open pickup zone. During a hover on a hoist mission he and the pilot 
alternated on the controls every five minutes. 

This practice of flying with two pilots originated in the early days 
of U.S. military involvement in Vietnam. Since the Korean War, 
helicopter detachments had flown with one pilot in the cockpit. The 
transportation aviation units which were in Vietnam when the 57th 
medical detachment deployed there in 1962 already had made it a 
policy to fly their H-21’s with two pilots in the cockpit. There were 
convincing reasons. If a solo pilot were wounded or killed by enemy 
gunfire his crew and ship would probably be lost, but a second pilot 
could take over the controls. A solo pilot also stood a good chance of 
getting lost over the sparsely populated Vietnamese countryside, 
where seasonal changes in precipitation produced great changes in the 
features of the terrain, making dead reckoning and pilotage difficult 
even for a pilot with excellent maps and aerial photographs. A second 
pilot could act as a navigator en route to and from a pickup zone. 

The 57 th quickly learned the value of two-pilot missions and asked 
for authorization to fly them. The denial they received referred to the 
official operator’s manual for the UH-1, which said that the 
helicopter, although equipped for two pilots, could be flown by one. 
Nevertheless, with seven aviators and only four aircraft, and one of those 


THE PILOT AT WORK 


77 


usually down for maintenance, the 57th usually flew their missions with 
two pilots up front. All the air ambulance units that followed adopted this 
practice, and eventually they obtained authorizations to do so. 

Besides the two pilots, an air ambulance usually carried a crew 
chief and medical corpsman. The crew chiefs most important pre¬ 
flight duty was preventive maintenance: keeping the aircraft flight¬ 
worthy through proper and timely inspections and repairs. He also 
had to make sure that the aircraft had all essential tools, equipment, 
and supplies on board. The medical corpsman’s only vital preflight 
duty was to supply the craft with the small amount of medical supplies 
that could be used in the short time taken by most evacuation flights: 
a basic first aid kit, morphine, intravenous fluids, basic resuscitative 
equipment, and scalpels and tubes for tracheostomies. At the pickup 
zone the crew chief and corpsman often worked together to load the 
casualties. If the hoist had to be used, one of them would operate it on 
the right side of the aircraft while the other stood in the opposite door, 
armed with a rifle to suppress enemy fire and to see that the aircraft 
stayed at a safe distance from obstacles. Once the patients were loaded, 
the crew chief helped the corpsman give them medical aid. 

The standard operating procedure of an air ambulance unit usually 
required one aircraft crew to be on alert at all times in “first up” status, 
ready to respond immediately to an urgent request. Like all am¬ 
bulance crews, the men sprang into action as soon as the siren in their 
lounge went off. Most units practiced often to cut the precious 
minutes needed to get their aircraft, warm the engine, and lift off. Many 
could get off in less than three minutes, unless the unit commander 
demanded a certain amount of preflight planning. Once aloft, the air¬ 
craft commander would open his radio to the Dust Off frequency and 
receive his assignment from the radio operator back at the base. 

He then turned the ship toward his objective, and at some point 
en route switched to the tactical frequency of the ground unit with the 
casualties. This allowed him to reassure the unit that help was on the 
way, assist the medical aidman on the ground in preparing for the 
evacuation, and check with the ground commander on dangers from 
the terrain, weather, or enemy. The method of approach to the 
pickup zone varied. Some units specified a standard approach, such 
as a steep, rapid descent from high altitude. But some of the most 
respected commanders believed in letting the aircraft commander use 
the many variables of the situation to determine the fastest, safest 
means of getting down to the wounded. 

On the ground the medical corpsman and the crew chief usually 
left the aircraft, put the patients on litters, and loaded them onto the 
ship. About half the time the casualty would not have received any 
medical treatment before he reached the air ambulance. When the 
hoist first went into operation, medical personnel publicized it and 


78 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


offered training in its use to ground combat and medical personnel. 
This reduced the likelihood that the medical corpsman would have to 
be lowered during a hoist mission to help load the patients, allowing 
either the corpsman or the crew chief to put down suppressive fire 
while the other lowered and raised the hoist cable. A few units, 
especially the organic air ambulances, routinely carried a fifth 
crewman during a hoist mission —a gunner to protect the ship, its 
crew, and its casualties. 

Once the patients were aboard and safely secured, the pilot took 
off. The corpsman tried to find and treat the most serious patient, and 
report the nature of the problem to the aircraft commander. The decision 
on where to fly the patients then entered the medical regulating net¬ 
work. The aircraft commander radioed the nearest responsible 
medical regulating officer, who confirmed or altered the commander’s 
choice of destination. This choice was based on the commander’s 
knowledge of the specialized surgical capabilities of the hospitals in his 
area and on his daily morning briefing as to the current surgical back¬ 
log in these hospitals. Standard practice was to take the most serious 
patient directly to a nearby hospital known to have all the equipment 
and care he immediately needed. If that hospital then determined that 
he needed more sophisticated care than it could offer, he was 
backhauled as far to the rear as possible. A secondary objective was to 
take the patient to the hospital in the area that had the smallest 
surgical backlog, to reduce the time between wounding and the start 
of surgery. The supporting medical group in each area of operations 
usually assigned, at least after 1966, a forward medical regulating of¬ 
ficer to each combat brigade headquarters, and those regulators kept 
aware of the most current surgical backlogs in all nearby hospitals. 
Since they had more current information on surgical backlogs than 
the aircraft commanders, the regulators had the authority to change 
the commander’s choice of destination. 

Since most pickups were made within range of a surgical, field, or 
evacuation hospital, the ambulances usually overflew the battalion 
aid stations and division clearing stations, which could offer only 
basic emergency treatment that was already available on the 
helicopter, and deposited the patients at a facility that offered 
definitive resuscitative treatment. Although the less serious patients 
often found themselves overevacuated, the practice saved thousands 
of patients who demanded immediate life-saving surgery. 

The effective functioning of an air ambulance depended heavily 
on its bank of four radios: FM, UHF, VHF, and single sideband 
(high frequency). The FM radio contained the frequencies of the Dust 
Off operations center, the tactical combat unit, and most hospitals. 
VHF and UHF were infrequently used. And the single sideband con¬ 
tained the medical regulating frequencies. The ambulance would 


THE PILOT AT WORK 


79 


usually stay on its Dust Off frequency for flight following until he ap¬ 
proached the pickup zone, when it would switch over to the tactical 
frequency of the unit with the casualties. After the pickup the am¬ 
bulance would switch briefly to the frequency of the forward medical 
regulator, which was closely monitored by his group medical 
regulating officer. Then the ambulance would switch back to the Dust 
Off frequency for flight following until it approached the hospital, 
when it would switch to the hospital’s frequency, usually on the FM 
radio, to warn the doctors of the approach. 

Although most of these procedures for area support missions also 
applied for direct support missions, there were a few important dif¬ 
ferences. Early in the war the 57th and 82d Medical Detachments, 
under the operational control of aviation battalions in the Delta, flew 
many such missions. The battalions would warn the detachments of 
planned airmobile operations and their requirements for aeromedical 
support. During a combat insertion, one or more Dust Off ships orbited 
near the landing zones at two or three thousand feet, out of effective 
small arms range, with the pilots monitoring the helicopter-to-ground 
talk on the FM band, helicopter gunship talk on UFIF, and any 
airplane-to-gunship talk on VHF. If a patient pickup became 
necessary during a ground fight, the command-and-control helicopter 
of the flight would designate two gunships to accompany the Dust Off 
ship into and out of the area. The gunships would switch over to the 
Dust Off frequency and make a slow pass over the area to draw fire, 
find the source, and suppress it. Then Dust Off would go in covered 
by the gunships. Later in the war organic air ambulances sometimes 
accompanied the flight of transport helicopters into the landing zones, 
and stood by waiting for casualties. More often they orbited the area 
of operations or stood by at the nearest battalion or divisional clearing 
station. While affording excellent aeromedical coverage for the sup¬ 
ported unit, direct support missions limited the ability of the air am¬ 
bulances to respond to emergencies elsewhere. 


Evacuation Problems 

All helicopter pilots in Vietnam had to cope with problems for 
which they might be unprepared or poorly equipped. By the nature of 
their work, air ambulance pilots experienced such problems more 
often than transport and gunship pilots. Except for the Medevac 
helicopters of the 1st Cavalry Division, the air ambulances carried no 
armament heavier than the pilots’ M16 rifles, and most of the air am¬ 
bulance missions were executed by a single ship rather than a well- 
prepared team, known as a “gaggle.” Soldiers were shot and injured 
without regard to the terrain or weather, and the air ambulances were 


80 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


expected to make their way to the casualties as soon as possible. The 
poor navigation equipment on the Hueys and the shortage of 
instrument-trained pilots early in the war exacerbated the difficulty of 
coping with South Vietnam’s weather. While maintenance problems 
plagued all the helicopter crews in South Vietnam, the special 
demands of air ambulance work, such as hoist missions, compounded 
the problems. Speed was important to inbound as well as outbound 
flights, making stops for refueling a dangerous luxury. While few of 
these problems could be totally solved, the air ambulance units often 
found ways to minimize them. When refueling during a mission could 
not be avoided, the unit often called ahead to an established fuel depot 
and made an appointment for refueling at an en route landing strip. 
When a unit was jointly based with a gunship battalion, arrangements 
could sometimes be made for an armed escort, especially on a hoist 
mission. 

One of the problems that persisted throughout the war was the ex¬ 
pectation that the air ambulances would transport the dead. Nothing 
in USARV regulations authorized the ambulances to carry the dead; 
but both ARVN and American soldiers expected this service. 
Nonmedical transport helicopters and gunships often evacuated both 
the dead and the wounded. If Dust Off ships had routinely refused to 
carry the dead even when they had extra cargo space, the combat 
units might have decided to rely exclusively on their transports and 
gunships to evacuate both the wounded and the dead, resulting in a 
marked decline in the care provided the wounded. Combat operations 
might also have suffered, for ARVN soldiers often would not advance 
until their dead had been evacuated. So most air ambulance units 
practiced carrying the dead if it did not jeopardize the life or limb of 
the wounded. 

The language barrier also hampered the work of the air am¬ 
bulance crews. Almost one-half the sick and wounded transported by 
the air ambulances could not speak English, and the crews usually 
could not speak enough Vietnamese, Korean, or Thai to com¬ 
municate with their passengers. Early in the war USARV regulations 
prohibited a response to an evacuation request unless an English- 
speaking person were at the pickup site to help the air ambulance 
crew make its approach and evaluate the patient’s needs, or unless the 
requesting unit supplied the air ambulance an interpreter. But the 
scarcity of good interpreters in the South Vietnamese Army meant that 
Dust Off evacuated many Vietnamese whose needs were only vaguely 
understood. Even when the air ambulance unit shared a base with an 
ARVN unit, the language problem proved serious. A former com¬ 
mander of the 254th Detachment remembered such an experience: 

The periodic attacks on the airfield were experiences to behold. Trying to get 


THE PILOT AT WORK 


81 


from our quarters to the airfield was the most dangerous. The Vietnamese 
soldiers responsible for airfield security didn’t speak English and with all the 
activity in the night —vehicles driving wildly about, people on the move, 
machine gun fire and mortar flares creating weird lighting and shadows — the 
guards were confused as to who should be allowed to enter the field and who 
had no reason to enter. If one could get to the field before the road barriers 
and automatic weapons were in place all was well. Later than that, one might 
just as well not even try to get on the field. We had several instances of the 
guards turning our officers back at gunpoint! We tried to get ID cards made 
but the Vietnamese refused to issue any cards. We sometimes felt we were in 
more danger trying to get to the airfield during alerts than we were picking 
up casualties. 

The pilots and crews also had to contend with the ever-present 
danger of a serious accident. Until later in the war most of the pilots 
lacked the instrument skills needed to cope with the poor visibility 
typical of night missions and weather missions. The DECCA naviga¬ 
tion system installed in the UH-lB’s and UH-lD’s proved virtually 
useless early in the war. More pilots died from night- and weather- 
induced accidents than from enemy fire. 

To cope with this danger, most of the pilots new to Vietnam 
quickly learned the virtue of a cool head and even a sense of humor. 
One former commander of a unit recalled the day that his alert crew 
at Qui Nhon received a request for the urgent evacuation of an 
American adviser who had fallen into a punji trap. (Such traps held 
sharpened wood stakes driven into the ground with the pointed ends 
facing up, often covered with feces, onto which the victims would step 
or fall.) It was late afternoon, approaching dusk, but Maj. William 
Ballinger and his pilot scrambled on the emergency call. They flew 
down the coast then turned inland to the pickup point. The casualty 
turned out to be a Vietnamese lieutenant with no more than a rash. 
Since they were already there, the crew picked him up and started 
back to Qui Nhon. 

On the way down the weather had turned bad, and when they 
headed north rain began. Night fell and the rain grew worse. 
Wondering whether they should set down or continue, they called the 
Qui Nhon tower operator and asked for the local weather. The 
operator reported a 3,000 foot ceiling and five miles visibility. The 
pilots thought they were in the middle of an isolated storm and they 
expected to break out shortly. After flying on and still not clearing the 
storm, they radioed the tower again and got the same report. Now 
their visibility was so bad they had to drop low and fly slowly up the 
beach. As they passed a point they knew to be only five miles from 
Qui Nhon, with the rain still pelting down, they again radioed the 
tower operator and got the same report: ceiling, 3,000 feet and five 
miles visibility. Ballinger asked for the source of the weather report. 


82 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


and the operator replied, “This is the official Saigon forecast for Qui 
Nhon.” Ballinger told the man to look outside the tower and then tell 
him what the weather was. The operator replied, “Oh, sir, you can’t 
see a damned thing out there.” The pilots had to fly low and slow to 
the base and were relieved when their skids touched the runway. Only 
then could they indulge in a good laugh. 

Night missions quickly became a major problem in themselves. 
The difficulties of such missions in a rural society were obvious: roads 
and population centers rarely were well lighted enough to aid in 
navigation to a pickup zone; terrain, especially in mountainous areas, 
became a great danger to ambulances that lacked adequate navigation 
instruments; and adequate lighting at the pickup zone rarely existed. In 
the dry season a landing light reflecting off the dust thrown up by the 
rotorwash could quickly blind a pilot just before touchdown. 
Throughout the war a considerable number of pilots and 
commanders refused to fly night missions or else flew them only for 
urgent cases. Others, however, thought that night flying offered many 
advantages that at least compensated for its problems. A few, such as 
Patrick Brady, even preferred night missions. 

Early in the war the 57th Detachment routinely flew night evacua¬ 
tions, so much so that at one staff meeting General Stilwell, the Sup¬ 
port Group commander, asked why the 57th could fly so well at night 
when few others could or would. He quickly learned that one of the 
aids used by the 57th was the AN/APX-44 transponder, which allowed 
Air Force radar stations to follow the aircraft at night or in bad 
weather and vector them to and from a pickup site. Early in 1964 
General Stilwell charged the medical detachment with the task of con¬ 
ducting a test on the feasibility of making combat assault insertions at 
night. In the Plain of Reeds the pilots experimented with parachute 
flares, tested the available radio and navigation equipment, and con¬ 
cluded that although night missions were suitable for medical evacua¬ 
tion they were not suitable for combat assaults. 

Night missions called for a few specialized techniques. En route at 
night to a pickup zone an air ambulance would fly with either its ex¬ 
ternal rotating beacon or position lights on. Once below 1,000 feet on 
its approach to the zone, it would douse these lights and dim its in¬ 
terior instrument panel lights as soon as the ship drew within range of 
enemy fire. About five hundred feet from the touchdown, the pilot 
would briefly turn on his landing light to get a quick look at the 
pickup zone. Then he would douse the landing light until the last 200 
feet of the approach. In an article in Army Aviation Digest, Capt. 
Patrick Brady recommended a final descent at right angles to the 
ground unit’s signal, since a pilot could see much better through the 
open side window than through the windshield, especially one 
covered with bulletproof plexiglass. On the ground the soldiers would 


THE PILOT AT WORK 


83 


use flashlights, small strobe lights, or vehicle headlights to mark the 
pickup zone. Some lights, such as flares, burning oil cans, and 
spotlights, tended to blind the pilot on final approach. A pilot in con¬ 
tact with soldiers on the ground would try to warn them of this early 
enough to allow a change of lights if necessary. On takeoff the lighting 
sequence on the ambulance would be reversed. 

While night magnified the dangers of weather and terrain. Cap¬ 
tain Brady correctly noted that it reduced the danger of enemy fire. 
Although the enemy would always hear the approach of the noisy 
Huey, he could rarely see it in the dark. An exhaust flame or the 
moonlight would sometimes betray a blacked-out aircraft, but the 
enemy could rarely direct accurate fire at the ship. Only night hoist 
missions allowed the enemy to get an accurate fix on an air ambulance, 
and the extreme hazards of hovering an aircraft close to ground 
obstacles at night made even the best air ambulance pilots avoid such 
missions unless a patient were in imminent danger of loss of life. 

A scarcely less dangerous form of night mission, a night pickup in 
the mountains in bad weather, was also beyond the capacity of most 
air ambulance pilots. Brady, however, developed a technique for such 
a mission that made it feasible if not safe for a highly competent pilot. 
One night in the fall of 1967, in Brady’s second tour in Vietnam, his 
unit, the 54th Detachment at Chu Lai, received a Dust Off request 
from a 101st Airborne Division patrol with many casualties in the 
mountains to the west. Heavy rains and fog covered the area, and 
after a few attempts Brady decided that he would never get to the 
casualties by trying to fly out beneath the weather. He would have to 
come down through the fog and rain with the mountains surrounding 
him. He took his aircraft up to 4,500 feet and vectored out to the 
mountains on instruments. As he approached the mountains he took 
his ship up to 7,000 feet. From his FM homing device he knew when 
he was directly over the pickup site. Then he radioed an Air Force 
flare ship in the area and asked its pilot to meet him high above the 
pickup zone and foul weather below. The Air Force pilot agreed and 
at Brady’s suggestion took his plane to 9,000 feet directly overhead 
and began to drop basketball-size parachute flares, larger and 
brighter than the Army’s mortar and artillery flares. Brady picked one 
out and started to circle it with his ship, dropping lower and lower into 
the fog, rain, and mist. The flare’s brilliant light reflecting off the fog 
and rain wrapped the Dust Off ship in a ball of luminous haze. Brady 
dropped still lower, gazing out of his open side window, alert for the 
silhouette of crags and peaks. Suddenly the ship broke through the 
clouds. Brady recognized the signal lights of the unit below him, and 
settled his ship onto the side of the mountain. He picked up the 
casualties and took off. Now that he was under the clouds he could see 
better, and he managed to fly back to Chu Lai at low level. Back at 


84 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


the base the rain was so heavy he could hardly see to land. While the 
patients were being unloaded, and the ship readied for a second trip 
out to the mountains, the 54th’s commander, Lt. Col. Robert D. 
McWilliam, went out to Brady’s ship and through the left window 
and asked the copilot how it was going. The young lieutenant just 
shook his head and said he couldn’t believe it. Knowing that the man 
was gung-ho, McWilliam thought he would not leave the ship until 
the mission was over. He asked him, “Would you like me to take over 
for you?” Instantly the man was out of the aircraft, and McWilliam 
took his place. 

As he and Brady flew back to the mountains, the ground control¬ 
ler vectored them into the middle of the thunderstorm. Lightning 
flashed around them, but Brady flew on to the pickup site, where he 
again managed to get down through the clouds using the Air Force 
flares. But this time he could not find the 101st patrol before the flares 
burnt out. Flying around in the dark only a few hundred feet off the 
valley floor, he and McWilliam strained to see the signal light of the 
beleaguered unit. Just as they saw it, an enemy .50-caliber machine 
gun opened fire on them. Brady jerked his craft around to avoid the 
fire, and he and McWilliam lost the signal. Having lost the enemy fire 
as well, they circled for several minutes trying to find the signal again. 
Suddenly the .50-caliber opened up at them again, and Brady knew 
that the U.S. forces had to be near. He managed to stay in the area 
this time, and soon the signal light flashed again. The Dust Off ship 
landed and flew out more casualties. 

Dust Off pilots often used Army artillery flares to light their 
pickup zone. But Major Brady had performed a far from standard 
night mission, using Air Force flares to descend through fog and rain 
in the mountains. In an article he wrote for Army Aviation Digest, 
Brady noted that such a mission did have its dangers, especially if the 
flares burned out before the ship had broken through the clouds. He 
wrote: “Nothing is more embarrassing than to find yourself in the 
clouds at 1,500 feet in 3,000-foot mountains and have the lights go 
out.” The pilot’s only recourse then was to climb as steeply as possible; 
if he tried to maintain position while waiting for another flare to come 
down, he ran the risk of drifting into the side of a mountain. Brady 
had demonstrated two qualities—imagination and courage —that 
helped many Dust Off pilots cope with the challenges of combat 
aeromedical evacuation. 


Enemy Fire 

Although pilot error and mechanical failure accounted for more 
aircraft and crew losses in Vietnam than enemy fire, the air am¬ 
bulance pilots worried more about the latter danger than the other 


THE PILOT AT WORK 


85 


more controllable ones. Once the buildup got under way in 1965, any 
air ambulance pilot who served a full, one-year tour could expect to 
have his aircraft hit by the enemy at least once. When hoist missions 
became a routine part of air ambulance work in late 1966, enemy fire 
became especially dangerous. Although the pilots devised ways of 
reducing the danger, such efforts barely kept pace with improvements 
in enemy weaponry and markmanship. 

Before the buildup began the pilots had little more than 
homemade weapons to fear. In 1962 and 1963 the 57th Air Am¬ 
bulance Detachment suffered less from enemy fire than the 
nonmedical helicopter units, partly because of the limited number of 
missions the unit flew in this period. The unit’s five ambulance heli¬ 
copters flew a total of only 2,800 hours those two years, and no pilot 
or crewman was wounded or killed in action. To get their minimum 
flight time and provide themselves some insurance against a lucky 
enemy hit, the pilots started flying two ships on each mission. But 
once the buildup got under way in late 1964 the unit went back to 
single ship missions, and most of the division and nondivisional air 
ambulance units that later joined them also followed this practice. 

The return to single-ship missions demanded a few unorthodox 
procedures. International custom and the Geneva Conventions, 
which the United States considered itself bound to observe, dictated 
that an ambulance not carry arms or ammunition and not engage in 
combat. But in Vietnam the frequent enemy fire at air ambulances 
marked with red crosses made this policy unrealistic. Early in the war 
the crews started taking along .45-caliber pistols, M14 rifles, and 
sometimes M79 grenade launchers. The ground crews installed extra 
armor plating on the backs and sides of the pilots’ seats. The hoist 
missions, introduced in the late fall of 1966, produced a high rate of 
aircraft losses and crewmember casualties. Although at this stage of 
the war gunship escorts for air ambulance missions were still hard to 
arrange, only the Air Ambulance Platoon of the 1st Cavalry responded 
to the new danger by putting machine guns on their aircraft. At first 
the unit simply suspended two M60’s on straps from the roof over the 
cargo doors. Later they installed fixed mechanical mountings for the 
guns. A platoon aircraft also usually carried a gunner as a fifth 
crewmember to handle one of the M60’s. Later in the war many of the 
air ambulance units, both divisional and nondivisional, tried to ar¬ 
range gunship escorts, especially for hoist missions, to pickup zones 
that had been called in as insecure. Throughout the war, however, 
such escorts proved hard to obtain, because aeromedical evacuation 
was always a secondary mission for a gunship in a combat zone. 

None of these defensive measures reduced the rate of air am¬ 
bulance losses in the war; they only prevented it from approaching a 
prohibitive level. Most of the Viet Cong and North Vietnamese 


86 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


soldiers clearly considered the air ambulances just another target. A 
Viet Cong document captured in early 1964 describing U.S. 
helicopters read: “The type used to transport commanders or 
casualties looks like a ladle. Lead this type aircraft 1 times its length 
when in flight. It is good to fire at the engine section when it is hovering 
or landing.” Fortunately Viet Cong weapons early in the war made a 
helicopter kill virtually impossible. Late in 1964, however, the North 
Vietnamese began to supply the Viet Cong with large amounts of 
sophisticated firearms: Chinese Communist copies of the Soviet 
AK47 assault rifle, the SKS semiautomatic carbine, and the RPD 
light machine gun. The introduction of these new enemy weapons in 
1965-66 and of the hoist missions in late 1966 caused a dramatic in¬ 
crease in 1967 in the rate of enemy hits on air ambulances. Only in 
April 1972, however, when the United States was well along in turn¬ 
ing the war over to the South Vietnamese, did the air ambulance have 
to contend with the Soviet SA-7 heat-seeking missile. This antiaircraft 
device was about five feet long, weighed thirty-three pounds, and had a 
range of almost six miles. A pilot had little warning of the missile’s ap¬ 
proach other than a quick glimpse of its white vapor trail just before it 
separated the tail boom from his aircraft. This weapon downed several 
air ambulances in the last year of U.S. participation in the war. 

The missile also disrupted the most elaborate effort the Army 
made during the war to reduce the losses of air ambulances: a change 
of their color. The 1949 Geneva Conventions did not require that air 
ambulances be painted white, and for their first nine years in Vietnam 
the Army’s air ambulances were the standard olive drab, medically 
marked only by red crosses on small white background squares. Early 
in the war many of the pilots thought that the crosses improved the 
enemy’s aim at their ships, and the unit commanders had to resist 
pressure to remove the markings. Arguing that they would be unable 
to keep aircraft that looked like transports dedicated to a medical mis¬ 
sion, the commanders prevailed, and the red crosses remained for the 
rest of the war. 

By mid-1971, however, the high loss rate for air ambulances over 
the last six years produced much doubt about the olive drab color 
scheme. Believing that making the aircraft more distinctive might be 
the answer, the Army Medical Command in Vietnam secured ap¬ 
proval in August to paint some of its aircraft white. The Command 
also was allowed to try to persuade the enemy that the white 
helicopters were for medical use only and should not be fired on. 
Thousands of posters were to be distributed and millions of leaflets 
dropped over enemy-held territory. The most elaborate leaflet read: 

Some new medical helicopters not only have Red Cross markings on all sides but 
they also are painted white instead of green. This is to help you recognize them 


THE PILOT AT WORK 


87 


better than before in order to give the wounded a better chance to get fast 
medical help. Like all other medical helicopters, these new white helicopters are 
not armed, do not carry ammunition, and their only mission is to save en¬ 
dangered lives without distinction as to civilians or soldiers, friend or foe. 


MEDICAL HELICOPTERS ARE USED FOR RESCUE MISSIONS 
AND THEY ARE NOT ENGAGED IN COMBAT. YOU SHOULD 
NOT FIRE AT THEM. 


An enemy soldier still intent on bringing down any U.S. helicopter 
would now find the white helicopters excellent targets against a back¬ 
ground of forests, hills, or mountains. All armaments now had to be 
removed from the ambulances, and gunship escorts could no longer 
furnish close support. Unless the information campaign were success¬ 
ful, the air ambulances would encounter more rather than less 
resistance. But the risk, while undeniable, seemed justifiable in view 
of combat loss statistics: from January 1970 through April 1971 the 
air ambulance combat loss rate was about 2.5 times as great as that 
for all Army helicopters. Something had to be done. 

The test program for white helicopters, begun on 1 October 1971, 
soon produced encouraging preliminary results. In November the Army 
medical command received permission to paint all of its remaining fifty 
air ambulances white. However, the drawdown of U.S. forces was 
now in full swing. The test, which terminated the following April, had 
begun too late in the conflict and with too few helicopters to produce 
conclusive results. The white helicopters at least had not proven any 
more dangerous than those painted olive drab. On 28 April 1972 the 
MACV Surgeon recommended to the Surgeon General that white 
helicopters continue to be used for medical evacuation by the dwindling 
number of Army units in Vietnam. 

But in the same month the enemy’s introduction of the heat¬ 
seeking SA7 missile to South Vietnam put Army medical planners in 
a new quandary. To navigate properly, most air ambulance pilots 
could not fly to and from a pickup zone at altitudes low enough to 
enable the enemy on the ground to discern the white color and the red 
crosses. Except at the pickup zone, the white ambulances were as 
vulnerable as any other Army olive drab aircraft. Between 1 July 
1972 and 8 January 1973 the enemy fired eight heat-seeking missiles 
at white air ambulances. The only protection against the SA7 was a 
new paint that reflected little of the engine’s infrared radiation but 
dried to a dull charcoal green. In January 1973 USARV/MACV 
Support Command directed that all U.S. Army air ambulances in 
Vietnam be painted with the new protective paint. Research began on 
a white protective paint, but before any significant progress could be 
made the war ended. 


369-454 0-82 


7 



88 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


A Turning Point 

By early 1968 the basic techniques of aeromedical evacuation 
developed during the Vietnam War had been perfected. The 
helicopters, rescue equipment, and operating procedures were now 
ready for a full test of their utility. Their first trial came in February 
1968 when the enemy launched a coordinated assault on allied bases 
and population centers throughout the country. With little warning 
the Dust Off system had to cope with thousands of casualties in all 
four Corps Zones. The enemy offensive resulted in more helicopter 
ambulances being shipped to South Vietnam, and by January 1969 
the system was only one platoon short of its peak strength. That year 
Dust Off carried more patients than in any other year of the war. 
Although the fighting then began to wane for U.S. forces, the Dust 
Off system still had to face two more ordeals: large operations in 
Cambodia and Laos. The final years of Dust Off in Vietnam proved 
to be the most difficult, and they earned helicopter evacuation a 
lasting place in modern medical technology. 


CHAPTER V 


From Tet To Stand-Down 

A reconsideration of the Vietnam War in 1968 by the American 
people and their government led to the withdrawal of U.S. combat 
forces from most of Southeast Asia by March 1973. After reports of a 
vast enemy offensive in South Vietnam in February 1968 reached the 
American public and the Johnson administration, support for the 
war, already less than firm, quickly waned. Although the coordinated 
enemy attacks heavily damaged several allied facilities and caused 
many casualties, the enemy itself suffered greatly in this futile attempt 
to topple the American-backed Republic of Vietnam. All in all, 1968 
proved to be a near military disaster for the Viet Cong and their 
North Vietnamese allies. But once the United States began to 
withdraw from South Vietnam by the end of the year, events on the 
battlefield had less and less influence on the overall American military 
policy in that country. This last and most trying period of the 
American experience in Vietnam severely tested the courage and 
dedication of the U.S. Army’s combat troops, including its Dust Off 
pilots and crews. 


Tet-1968 

By the end of 1967 the enemy had staged large attacks on the 
border areas at Song Be, Loc Ninh, and Dak To. The enemy had 
done much the same in February 1954, just a month before the open¬ 
ing of the final campaign at Dien Bien Phu. Their strategem almost 
worked again. In early December 1967 Generals Westmoreland and 
Cao Van Vien, chief of the South Vietnamese Joint General Staff, 
discussed the coming Christmas, New Year, and Lunar New Year 
(Tet) ceasefires. In a show of confidence on 15 December, Westmore¬ 
land transferred the responsibility for defending Saigon to the ARVN 
forces and began to move large numbers of U.S. troops outside the 
Saigon area. But in early January the allies intercepted a message in¬ 
structing the rebel troops to flood the Mekong Delta, attack Saigon, and 
launch a general offensive and uprising. On 10 January 
Westmoreland, after hearing the advice of Lt. Gen. Fred Weyand, 
the commander of II Field Force, Vietnam, began shifting combat 
units back from the border areas to Saigon. By 20 January U.S. 


90 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


Strength in Saigon had almost been restored to its previous high level. 
Westmoreland warned his superiors that the enemy might attack 
before or after the Tet holiday, which would last seven days starting 
30 January, but he doubted that they would violate the traditional 
holiday truce itself. 

On 20 January the enemy started their final diversion: a bom¬ 
bardment of the U.S. Marine Base at Khe Sanh in northern I Corps 
Zone. This siege continued some eleven weeks, well beyond the collapse 
of the Tet offensive, and demanded a large-scale rescue effort by U.S. 
forces in the north. On the morning of 30 January, the start of the Tet 
holiday, some Viet Cong units prematurely attacked seven cities. The 
main enemy attacks began the next day throughout the country and 
continued through 11 February. Although the allied command on 30 
January cancelled all holiday leave for military personnel, few 
soldiers returned to their posts quickly enough to help stem the main 
attacks. The enemy failed to provoke a national uprising, and suf¬ 
fered heavy losses. But the Tet offensive damaged many allied, 
especially South Vietnamese, facilities and caused thousands of allied 
civilian and military casualties. 

Enemy attacks on allied bases quickly drew Dust Off into the thick 
of the fighting. In the north the 43d Medical Group suffered damage 
to many of its dispersed aircraft. All medical units, both north and 
south, had been warned at least a few hours in advance to expect 
heavy casualties, but the offensive still almost swamped all allied 
hospitals and clinics. On 1 February the 43d Medical Group, with the 
44th Brigade’s approval, requested a C-141 for a special mission, 
evacuating as many U.S. casualties as possible from the 6th Con¬ 
valescent Center, the 8th Field Hospital, and the 91st Evacuation 
Hospital, to make room for the continuing influx of wounded. CH-47 
Chinook helicopters evacuated many patients between hospitals and 
casualty staging facilities. 

On 1 February the 44th Medical Brigade’s aviation officer told the 
various medical groups that all helicopter ambulance detachments 
were limited to twelve pilots, regardless of any other authorization. 
Both pilots and machines had become critically short. If any of the 
43d’s detachments should run into severe problems, it was to turn to 
the 55th Group and the 498th Medical Company. Later the 43d 
Group did have to call on the 55th Group for substitute aircraft. Only 
the somewhat sporadic nature of the fighting allowed the medical 
system to keep up with the inflow of patients. 

At the start of the Tet offensive, the air ambulance detachments in 
the south were no better prepared for the onslaught of wounded than 
those in the north. The 44th Brigade began to keep constant watch on 
the status of the aircraft with each detachment so it could redistribute 
the flyable aircraft to the detachment in greatest need. But fighting 


FROM TET TO STAND-DOWN 


91 


soon inflicted a great deal of damage to the Dust Off aircraft 
throughout South Vietnam. 

The problems of the 45th Medical Company and the 57th Detach¬ 
ment, both stationed at Long Binh outside Saigon, were typical. By 
midday on 1 February both units had notified the 67th Medical 
Group that they needed a hospital to receive ARVN patients, but the 
only one with any beds still open was at Vung Tau, sixty-five 
kilometers from Saigon on the coast. Since the 45th was down to 
seven flyable aircraft of its complement of twenty-five, the 44th 
Brigade gave it two aircraft from the 43d Medical Group. By the time 
the fighting subsided, twenty-two of the 45th’s aircraft had been 
damaged. Some administrative delays were avoided during the 
fighting when the 67th and 68th Medical Groups allowed the 45th 
Company to coordinate directly with the 57th for such mutual support 
as they needed. 

Tet swept through the Delta as it did elsewhere. The 82d Medical 
Detachment at Soc Trang had to support the U.S. 9th Infantry Divi¬ 
sion, three ARVN divisions, the 164th Aviation Group, and scattered 
Special Forces units. In February the pilots evacuated over 1,400 
patients. The unit lost three aircraft the first night of the offensive. 
First up that night, Capt. Harvey Heuter, flew to Can Tho to pick up 
three casualties, then proceeded to Vinh Long for more, on his way to 
the 3d Surgical Hospital at Dong Tam. Vinh Long was wrapped in 
close-up fighting, even on the airstrip. After he left the strip with his 
first load, Heuter radioed his unit that from the air the friendly 
soldiers were indistinguishable from the enemy; he recommended the 
front of the dispensary as the safest place for the next helicopter to 
land for the rest of the casualties. While gunships orbited and fired 
when they could clearly see enemy on the ground, another 82d ship, 
piloted by Capt. A1 Nichols, flew into Vinh Long and out again, tak¬ 
ing fire both ways. The 82d often had to borrow aircraft, and 
sometimes it used pilots from other units to keep up with the missions. 

Whereas most of the fighting in the Tet offensive lasted only a few 
days, the fighting in the ancient city of Hue, near the coast in northern I 
Corps Zone, raged for twenty-five days. The Army’s 1st Cavalry 
Division had started moving north in January to conduct joint opera¬ 
tions with the U.S. Marines and possibly to take part in a relief opera¬ 
tion toward the Marine base at Khe Sanh. The Air Ambulance Pla¬ 
toon moved with them to the airstrip that served Hue and adjacent 
Phu Bai. After one night at Phu Bai the Air Ambulance Platoon 
pitched their tents in an area nearer Hue that they appropriately 
named “Tombstone”—their base was in a graveyard. The same area 
later became Camp Eagle when the 101st Airborne set up its division 
base there. After a few nights at Tombstone, and a few Viet Cong mortar 
attacks, the platoon moved north with the 1st Cavalry to a new base. 


92 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


Camp Evans, a former Marine base along Route 1 toward Quang Tri. 
The platoon then dispersed its twelve aircraft among five locations. 

C3n the morning of 31 January some seven thousand enemy 
soldiers, mostly North Vietnamese regulars, swarmed over Hue and 
seized all of the city except the Imperial Palace and the MACV com¬ 
pound across the Perfume River. Maj. Dorris C. Goodman, the pla¬ 
toon commander, and Capt. Lewis Jones pulled the first evacuation 
mission out of Hue. They low-leveled down the Perfume River into 
the city. At the pickup site, they found that the patients were not yet 
ready. After flying back to the River, they hovered between two gun- 
ships until called back in to complete the pickup. They then low- 
leveled out the way they had come in. Other Medevac ships followed 
them along the same route in the days of fighting that followed. As in 
the south, the air ambulances proved how necessary they were. Land¬ 
ing on tops of buildings and in city streets, using their hoists for in¬ 
accessible areas, the crews flew round the clock, not only to evacuate 
the wounded but also to move patients from overcrowded hospitals to 
other medical facilities. The Air Ambulance Platoon, the 571st 
Medical Detachment, and elements of the 498th Medical Company 
took part in Operation Pegasus, a joint allied operation in early April 
to relieve the Khe Sanh combat base. 

One of the most dramatic Dust Off missions in the north came 
shortly after a platoon of the 101st Airborne on the night of 3 April set 
up camp about five miles southeast of fire support base Bastogne on 
Highway 547 west of Hue. The mountains around them were dark, 
drenched with rain, and covered in fog. About 0100 the enemy probed 
the camp’s perimeter with automatic weapons fire, then launched a 
ground attack. It was quickly beaten off, but two U.S. soldiers were 
critically wounded. The platoon leader called for Dust Off and 
specified that the mission required a hoist. The 101st Brigade Surgeon 
monitored the call and advised Dust Off to wait until daybreak to 
attempt the mission, since to fly that night with no visibility would 
court disaster. Lieutenants Michael M. Meyer and Benjamin M. 
Knisely cranked as soon as the mission request came through again at 
dawn. They set up a high orbit while waiting for the C-model gun- 
ships to fly out from Hue to cover them, but the gunships radioed they 
could not get out because of the fog. Meyer made a low pass over the 
area and, although the platoon leader did not mark his position with 
smoke, Meyer’s crew made a fairly good identification by radio. The 
ground unit told Dust Off they had received a few rockets and consider¬ 
able small arms fire, and they suggested he wait for guns to cover the 
mission. Meyer returned to Phu Bai to refuel and get his gun team. 

At noon the Dust Off ship started out again to pull the two original 
casualties and three newly wounded soldiers, but this time with two 
UH-IC gunships alongside. Once in the area, the gunships made 


FROM TET TO STAND-DOWN 


93 


several passes in the vicinity of the platoon to draw fire, but they took 
none. Meyer shot his approach up the valley and came to a hover. 
The medical corpsman and crew chief had trouble seeing down 
through the trees. Finally the corpsman said he could see people on 
the ground and started the hoist cable on its way down. 

Just then the gun team leader saw a trail of white smoke streaking 
toward the red cross on the fully opened cargo door, but before he 
could radio a warning a rocket struck and exploded. The aircraft, 
engulfed in flames, half flew, half bounced almost a quarter of a mile 
down the tree-covered hillside. The last thing Knisely remembered 
was the cargo door flying past his window. His helmeted head struck 
the door jamb and he passed out. The burning ship crashed down 
through the trees and came to rest on its left side. Meyer climbed out 
of the ship and started running, but stopped when he heard scream¬ 
ing, and returned. He kicked out the windshield, reached in, and un¬ 
buckled the unconscious Knisely who fell forward against the instru¬ 
ment panel. As he did so, a fuel cell in the belly of the ship exploded 
and blew Meyer away from it. He returned a second time, removed 
Knisely’s helmet and pulled him from the ship. With his bare hands 
he patted out the burning jungle fatigues and then dragged his inert 
pilot a safe distance away. Before he could return to see if the crew 
were still alive, machine gun rounds started cooking off and the ship 
completely burned, an inferno of magnesium and synthetics. Later that 
afternoon Knisely regained consciousness, but neither of the pilots 
wanted to move very far. The ship was no more than a pile of ashes. 

About 1700, hearing sounds of people approaching, Meyer and 
Knisely, both injured and unarmed, could do no more than crawl further 
under the bushes. From the voices, they immediately decided their 
visitors were not of English extraction. Just as the North Vietnamese 
troops arrived, an American rescue party also appeared and a skir¬ 
mish broke out. For twenty minutes bullets whizzed and whined 
overhead and around the smoldering ashes of the Dust Off ship. The 
North Vietnamese finally broke contact and escaped down the hill. 

The downed crew heard voices calling out in English. They were 
still afraid to answer but Meyer finally called out. The patrol was 
from the platoon —a lieutenant, a radioman, a medical corpsman, 
and several soldiers who had volunteered to work their way down the 
hill to the crash site and to rescue any survivors. They had not ex¬ 
pected to run into the North Vietnamese patrol. It had taken them 
five hours to get to Meyer and Knisely. The corpsman checked them 
both over carefully: both of Meyer’s hands were burned and one was 
broken, and Knisely had third-degree burns on one arm, lesser burns 
on his face, and a broken ankle. The trip back up the hill to the defen¬ 
sive perimeter was torturous for all concerned. Knisely, only intermit¬ 
tently conscious, could not walk and had to be carried or dragged. 


94 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


The group made only a few hundred meters that first night. 

While clambering up the hill the next morning, they heard 
shouting from overhead. They looked up a nearby tree and saw the 
medical corpsman, who had been thrown from the aircraft as it 
careened down the hillside. The party got him down and found that 
he had a broken hip and various bruises and contusions, but 
altogether he was a very lucky lad. The crewchief, Sp4c. James E. 
Richardson, had perished in the inferno of the crash. 

Early that afternoon, the rescue party and the three Dust Off sur¬ 
vivors rejoined the platoon where they learned that one of the gunshot 
victims had died. Because the enemy was still around in force. Dust 
Off could not get into the area without hazarding another loss. The 
downed crew told the ships overhead that it was not really urgent to 
get them out. They spent a second night on the ground. 

Next day, when Lt. Col. Byron P. Howlett, Jr., the 498th’s com¬ 
mander, heard of the crash, he and one of the platoon leaders jumped 
into an aircraft and flew the three hours from Qui Nhon to Phu Bai to 
hasten the extraction. Once there. Colonel Howlett declared that he 
was going to pull the mission no matter what. The next morning, he 
flew out and orbited the area with several gunship escorts to protect 
the attempt. One of the gunships dropped several blocks of plastic ex¬ 
plosive so that the platoon below could blast out a landing zone. But 
the trees proved too dense to clear much more than a 30-by-30-foot 
area, far too small for a Huey to land in. By noon all the platoon and 
the crew were in the middle of the clearing. A Skyraider made several 
passes on the hill near the clearing, followed by Huey gunships. Then 
Dust Off, piloted by Howlett, flew in, hoisted out the three most 
serious casualties, all from the 101st, and evacuated them to the clear¬ 
ing station at Bastogne. A 571st ship flew in next, hoisted out several 
more wounded, and departed. On the third extraction. Colonel 
Howlett pulled Meyer and Knisely. The two ships had hoisted 
twenty-three wounded. 

The Drawdown Begins 

The war changed considerably after the enemy defeat during the 
Tet Offensive of 1968. By the end of the year many North Viet¬ 
namese units had withdrawn to Cambodia and Laos, leaving behind 
smaller units to harass the allied forces. The Military Assistance 
Command responded by adopting new tactics for its ground forces, 
using small units against precise objectives rather than large forces on 
area sweeps. These changes, however, did not immediately affect the 
well-established system of medical evacuation. By the end of the year 
air ambulance coverage was at its peak. Though the 50th Detachment 
was deactivated on 1 July, it soon reappeared as the twelve-helicopter 


FROM TET TO STAND-DOWN 


95 

Air Ambulance Platoon of the 326th Medical Battalion, 101st Airborne 
Division (Airmobile), in northern I Corps Zone. The platoon quickly 
became known as Eagle Dust Off, the second air ambulance platoon in 
South Vietnam, joining the Medevac platoon of the 1st Cavalry. 

In 1969 the war changed in several important ways. The 
diplomats in Paris conducting peace negotiations, which had begun 
after Tet, put procedural questions aside and began to concentrate on 
substantive issues. Ho Chi Minh died and was replaced by a collec¬ 
tive leadership in North Vietnam. In the United States, the ad¬ 
ministration of President Richard M. Nixon, facing ever stronger 
domestic opposition to the war, announced the first of a series of 
withdrawals of U.S. troops from Vietnam. In March 1969, U.S. 
forces in Vietnam totaled 541,000, the peak level of American in¬ 
volvement. But in June, September, and December, President Nixon 
announced phased withdrawals of 110,000 U.S. personnel. The 
United States told the Republic of Vietnam that eventually it would 
have to defend itself without the aid of American ground combat 
forces. 

The changes in the war produced changes in the Army’s system of 
medical care. In the summer of 1969, the 44th Medical Brigade was 
removed from the 1st Logistical Command and assigned directly to 
U.S. Army, Vietnam. Eliminating that link in the chain of command 
greatly increased the brigade’s influence. As combat and support 
units began to leave South Vietnam, U.S. troop locations and 
assignments changed rapidly, demanding equally rapid reassessments 
and readjustments of the medical support structure. Hospitals closed, 
reduced their holding capacity, or relocated. Coordination at the 
MACV level and between the various service components became 
vital. 

In the summer of 1969, the 44th Medical Brigade deactivated the 
55th Medical Group, which had never commanded aeromedical 
evacuation units, and thereby reduced its groups in Vietnam to three: 
the 67th in I Corps Zone, the 43d in II Corps Zone, and the 68th in 
III and IV Corps Zones. On 15 January 1970 the 44th Brigade further 
reduced its medical groups by deactivating the 43d at Nha Trang. 
The 67th Group at Da Nang then assumed control of I Corps Zone 
and the northern half of II Corps Zone; the 68th Group at Bien Hoa 
took the southern half of II Corps Zone along with III and IV Corps 
Zones. At that time the 44th Brigade exercised command and control 
over all U.S. Army medical resources in South Vietnam, except for 
those organic to combat units. The USARV Surgeon General’s office 
existed as a separate staff element under USARV headquarters. 
Since this produced much duplication of function and effort, on 1 
March 1970 the headquarters of the 44th Medical Brigade and the 
USARV Surgeon’s office merged to form the U.S. Army Medical 


96 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


Command, Vietnam (Provisional) (MEDCOM). The MEDCOM 
commander, Brig. Gen. David E. Thomas, also held the position of 
USARV Surgeon. 


A Second Medal of Honor 

Even as the draw^down got under way, in October 1969 Dust Off 
showed that its pilots could be heroes in times of withdrawal. CW3 
Michael J. Novosel, a pilot of the 82d Medical Detachment, 45th 
Medical Company, 68th Medical Group, stationed at Binh Thuy in 
the Delta, seemed an unlikely hero. Forty-eight years old and a father 
of four, he was in his second tour of duty in Vietnam. In 1964 he had 
abandoned a lucrative pilot’s job with Southern Airways and the rank 
of lieutenant colonel in the Air Force Reserve to serve as an Army 
pilot in Vietnam, where he joined the Dust Off team. Four times a 
day he applied medication to his eyes to treat the glaucoma whose 
onset had recently prevented him from returning to work as a civilian 
airline pilot. Only because the Army had granted him a waiver for his 
condition was he now back in Vietnam, again serving as a Dust Off 
pilot. Standing only five feet four inches, weighing less than 150 
pounds, he lacked the physical characteristics of the stereotypical 
military hero. But he possessed qualities that were more important 
than physical prowess. 

On the morning of 2 October 1969 the right flank of a three- 
company ARVN force came under intense fire as it moved into an 
enemy training ground right on the Cambodian border in the Delta 
province of Kien Tuong. During the next six hours U.S. Air Force 
tactical air support and Army gunships tried several times to enable 
the stranded soldiers to escape. Most of the uninjured soldiers'man¬ 
aged to retreat some two thousand meters south, but others, finding 
their retreat blocked by high waters in swamps and rice paddies, 
could not get out. Several who had been wounded lay scattered about 
where they had been hit, near a group of bunkers and two forts used 
by the enemy in training exercises for simulated attacks on South 
Vietnamese installations. 

In the midafternoon a U.S. Army command-and-control heli¬ 
copter above the battleground radioed for a Dust Off ship. Operations 
control of the 82d Detachment relayed the request to Dust Off 88, 
whose aircraft commander, Mr. Novosel, and pilot, WOl Tyrone 
Chamberlain, had already flown seven hours of missions that day. 
The crew chief was Sp4c. Joseph Horvath and the medical corpsman 
was Sp4c. Herbert Heinold. Norosel immediately headed toward the 
border. Since the wounded ARVN soldiers did not show themselves 
on his first two hotly contested approaches to the area, Novosel circled 
at a safer range to signal the wounded to prepare for an evacuation. 


FROM TET TO STAND-DOWN 


97 

Finally one soldier had the nerve to stand up in elephant grass and 
wave his shirt overhead. Novosel dropped his ship into the area again 
and skidded along the ground toward him. The crew scooped the 
soldier up and took off. 

After that, by ones and twos, the ARVN soldiers waved to the 
circling helicopter that continued to draw enemy fire. Four soldiers 
stood up and Dust Off 88 picked them all up on one approach. Enemy 
machine guns killed at least one other soldier as he signaled. At 1730, 
Dust Off 88 dropped the first load of casualties off at the Special 
Forces camp at Moc Hoa, refueled, and headed back to the fray. 
While Chamberlain monitored the instruments and tried to spot the 
casualties, Horvath and Heinold hung out both sides of the aircraft on 
the skids, grabbing people when they could and pulling them inside 
the ship. Where the elephant grass was so tall that it prevented land¬ 
ing, Horvath and Heinold hung onto litter straps to reach far enough 
down to grab the men below. 

During the second series of lifts, while Novosel hovered at a safe 
range. Air Force F-lOO’s roared down on the enemy, dropping 
500-pound bombs and firing 20-mm. cannon. But when Dust Off 88 
went back in for the wounded, enemy fire was still extremely intense. 

The second group of ARVN soldiers were seriously wounded. 
One had a hand blown apart; another had lost part of his intestines; 
another was shot in the nose and mouth. As soon as the ship left the 
area for Moc Hoa, Heinold began tending the more seriously injured, 
applying basic lifesaving first aid, to make sure the wounded were 
breathing and that the bleeding was momentarily stanched. During 
the fifteen minute flight back he also managed to start intravenous in¬ 
jections on those he thought were low on blood or going into shock. 

Although the enemy fire knocked out the VHF radio and airspeed 
indicator early in the mission, Novosel continued to fly. At least six 
times enemy fire forced him out of the area. Each time he came back 
in from another direction, searching for gaps in the enemy’s fixed field 
of fire from the fort and numerous bunkers. Between his three trips to 
the area Novosel used his craft to guide the withdrawal of stragglers 
around the swamps and rice paddies. 

On the last of his trips, with dusk approaching, a pair of AH-IG 
Cobra gunships gave the helicopter some covering fire. At 1900, when 
nine casualties were already on board, Horvath told Novosel that a 
man close to a bunker was waving to them. Suspecting that something 
was awry, Novosel told his crew to stay low in the ship while he 
hovered backwards toward the man, putting as much of the airframe 
as possible between the bunker and his men. As soon as the soldier 
was close enough, Horvath grabbed his hand and started pulling him 
into the ship. Before he could get him in, an enemy soldier stood up in 
the grass about thirty feet in front of the ship. He opened fire with his 


98 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


AK47, aiming directly at Novosel. Bullets passed on either side of 
him. One deflected off the sole of his shoe, and plexiglass fragments 
from the windshield hit his right hand. Shrapnel and plexiglass buried 
in his right calf and thigh. Both in pain and disgust, and to warn the 
copilot, Novosel shouted, “Aw hell, Fm hit.” The aircraft momentari¬ 
ly went out of control and leaped sixty feet into the air. The ARVN 
soldier Horvath had been pulling aboard slipped off the ship, but 
Horvath kept his grip and pulled him back in. As he did so, he fell 
backwards on some of the men already there and cut his neck on their 
equipment. Chamberlain got on the aircraft controls with Novosel 
and they flew back to Moc Hoa. They shut down the engine, unload¬ 
ed the wounded, and inspected their ship. Despite several hits to the 
rotor system and the cockpit, the aircraft could fly. The crew returned 
to Binh Thuy, ending their work after eleven hours in the air. They 
had evacuated twenty-nine wounded ARVN soldiers, only one of 
whom died. For this, Novosel was awarded the Medal of Honor. 

VNAF Dust Off 

In spite of the bravery of Army Dust Off pilots like Mr. Novosel, 
the Vietnamization of the war required that the South Vietnamese 
Army rapidly develop its own Dust Off system. The United States in 
May 1956 had taken responsibility for training and advising the 
South Vietnamese Air Force. The United States soon supplied the 
Vietnamese with H-19 helicopters, and later replaced them with 
H-34’s. In August 1965 the Vietnamese Air Force received U.S.- 
made B-57 Canberra bombers, its first jet aircraft. In October of the 
same year it received its first UH-lB’s. By the end of 1972, as a result 
of Vietnamization, it owned 500 new helicopters, organized in eigh¬ 
teen squadrons —“one of the largest, costliest, and most modern 
helicopter fleets in the world.” By July 1972 U.S. flight schools in the 
continental United States had graduated 1,642 South Vietnamese 
helicopter pilots. No materiel or personnel shortages prevented the 
creation of an effective VNAF Dust Off system. 

From the very first years of Dust Off in Vietnam, Army regula¬ 
tions specified that the primary responsibility for aeromedical evacua¬ 
tion of ARVN casualties lay with the South Vietnamese Air Force. 
ARVN officers were supposed to refer missions to the U.S. medical 
regulators only when their Air Force could not fly the mission. But in 
practice this regulation was often ignored. In November 1968 the 
USARV commanding general cabled all Army commands in the 
country: “Attempts to supplant VNAF with USARV resources or to 
allow requests for medevac of ARVN troops to go directly to USARV 
elements without first asking for VNAF precludes the RVN from 
developing effective aeromedical evacuation capabilities. Com¬ 
manders are enjoined to prohibit such attempts.” 


FROM TET TO STAND-DOWN 


99 


Medical Command, Vietnam, responded to this directive by 
changing several elements of USARV Regulation 40-10, concerning 
aeromedical evacuation, to try to prevent Dust Off from accepting 
Vietnamese missions except when the case was urgent and the RVN 
Air Force fully committed elsewhere. The only civilians to be 
evacuated were those in the Civilian War Casualty Program. But the 
problem would not go away. A MEDCOM staff officer wrote to the 
Surgeon General’s office: “It is definitely an uphill fight mainly 
because VNAF controls the aircraft and our USAF are their advisors. 
Our USAF has gone on record stating that dedicated aircraft for bat¬ 
tlefield evacuation is ridiculous and a waste of assets. This policy has 
made it impossible to get our foot in the door thus far.” 

In February and March 1969 several U.S. commanders in Viet¬ 
nam urged the creation of a Dust Off training program for VNAF 
pilots and medical corpsmen. One commander even suggested giving 
the RVN Air Force thirty-six new helicopters if they would promise to 
dedicate them exclusively to air ambulance missions. Over the next 
two years several attempts to work out a plan for attaching VNAF 
pilots and medical corpsmen to American Dust Off units failed 
because of disputes between the U.S. Army and U.S. Air Force over 
the concept of dedicated aircraft, because of the seemingly intractable 
nature of the language barrier, and because of the reluctance of the 
RVN Air Force to accept responsibility for its own Dust Off program. 

Finally on 3 March 1971, after almost two years of talks and four 
months of preparation, the 57th and 82d Medical Detachments in IV 
Corps Zone started a Dust Off training program for VNAF helicopter 
pilots and crews. The Americans soon observed that the VNAF pilots 
learned faster than was expected. The two detachments arranged a 
rest area for the VNAF crews, allowed them to eat at U.S. Army mess 
halls, but flew them back to their base at Binh Thuy, near Can Tho, 
at the end of the day. On 21 March the first all-VNAF crew flew out 
of Binh Thuy on a Dust Off pickup. By September the program had 
trained some fifty VNAF pilots and crews in Dust Off procedures. 
Similar efforts in the other Corps Zones were also successful. Between 
late May and the end of October a similar program at Long Binh 
could graduate only nine of the twenty VNAF pilots who started. 
Three of those who graduated, however, started training other VNAF 
pilots; so by the end of November VNAF Dust Off crews were flying 
70 percent of the patients in III Corps Zone. Similar programs in I 
and II Corps Zones ended in early 1972 with good results. By January 
1972 all four programs had trained eighty-three VNAF pilots, twenty- 
one crew chiefs, and twenty-eight medical corpsmen, all of whom 
were considered fully qualified. 

In addition to this training program, the MACV Surgeon’s office 
saw that the number of VNAF Dust Off aircraft increased in step with 

t 


100 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


Vietnamization. From 1 November 1971 to 30 April 1972, as a part of 
the overall U.S. withdrawal, the U.S. Army gave the South Viet¬ 
namese armed forces 270 UH-IH utility helicopters, 101 O-IG light 
observation helicopters, and 16 CH-47 Chinook transport 

helicopters. The MACV Surgeon’s office tried to ensure that about 
6.5 percent of VNAF helicopters would be permanently dedicated 
medical evacuation ships. MACV planners fully realized that this 
minimal allocation would be inadequate to cover civilian casualties 
and nonurgent military casualties as well as urgent military 
casualties. But they considered it the best they could hope for. 

During this period of rapidly dwindling resources, the U.S. Army 
Dust Off program experimented with a new form of organization — 
the medical evacuation battalion —that proved to be more successful 
than the medical evacuation company. Plans for such a unit 
originated in July 1969, just as the first stand-downs from Viet¬ 
namization began to take place in the 9th Division. On 1 August, the 
54th Medical Detachment (Helicopter Ambulance) at Chu Lai 
created a similar unit by taking over the operational control of a den¬ 
tal service team, a preventive medical team, a veterinary detachment, 
and the 566th Medical Company (Ambulance). Although this new 
organization provided professional services other than medical 
transportation, it foreshadowed the medical evacuation battalion by 
combining surface and air evacuation assets. 

In February 1970 the 44th Medical Brigade started to convert the 
61st Medical Battalion at Cam Ranh Bay into just such a battalion. 
The brigade stripped the 61st of its responsibility for treating patients, 
then relocated it northward to Qui Nhon. When it became opera¬ 
tional on 26 February 1970, the 61st started to control all nondivi- 
sional ambulances in the northern half of South Vietnam. The mis¬ 
sion of the battalion was considerably broader than that of a detach¬ 
ment or company; it had to provide ground as well as air transport, 
and move not only patients but also medical personnel, supplies, and 
equipment. 

To accomplish this mission, the battalion had six helicopter am¬ 
bulance detachments, two ground ambulance detachments, one bus 
ambulance detachment, and one air ambulance company —a total of 
sixty-one UH-IH helicopters, eighty-seven 3/4-ton ambulances, and 
three bus ambulances. To improve the command structure of the bat¬ 
talion, its commander formed smaller air ambulance “detachment 
groups.” A MEDCOM aviation officer explained the rationale behind 
the action: 

We are paying some high penalties because of the lack of experienced 
aviators. We just do not have enough second-tour types to provide a com¬ 
mander for each unit. Our average for both commissioned and warrant se¬ 
cond tours is far below the USARV average. In an effort to compensate for 


FROM TET TO STAND-DOWN 


101 


this lack of experience “Detachment Groups” have been formed, where two 
or more detachments are located in close proximity, with the senior aviator 
assigned controlling and coordinating activities. We hope this will give us 
better control and take maximum advantage of the experience we do have. 

The 283d air ambulance detachment was put under the 498th 
Medical Company (Air Ambulance), the 236th and 237th air am¬ 
bulance detachments under the 571st air ambulance detachment, and 
the 68th air ambulance detachment under the 54th air ambulance 
detachment. 

The 61st Medical Evacuation Battalion proved successful. Air¬ 
craft availability rates increased 20 percent and the battalion’s units 
passed their command inspections with flying colors. Plans were 
made for a second battalion. On 1 May 1970 the 58th Medical Bat¬ 
talion became the 58th Medical Evacuation Battalion, with its head¬ 
quarters at Long Binh. Its mission was to provide coverage for 
southern II Corps Zone, and III and IV Corps Zones. The battalion 
had fifty-five UH-IH helicopters to support this area. 

Eor a year the two evacuation battalions performed their tasks 
very well. But by the spring of 1971 the declining personnel ceilings in 
Vietnam had made the battalions an unaffordable luxury. Medical 
Command, Vietnam, prepared to deactivate the battalions and 
transfer many of their functions to the staff of the 67th and 68th 
Medical Groups. On 10 June both battalions totally disbanded. 

Cambodia 

From the early 1960s the North Vietnamese Army had brought 
supplies and troops into South Vietnam along the Ho Chi Minh Trail 
running south through the Laotian panhandle and eastern Cam¬ 
bodia, and along the trails running northeast from the Cambodian 
coast on the Gulf of Thailand. In 1967 the United States began covert 
operations, code-named Salem House, against these enemy supply 
routes. Although limited in size and scope —each incursion team had 
a maximum of twelve allied soldiers, including three American 
soldiers, and a maximum penetration of twenty kilometers into Cam¬ 
bodia—some 1,400 Salem House missions took place from 1967 
through 1970. 

In early 1970 the U.S. military leaders in Vietnam saw the need 
for larger strikes against the supply routes. Insurgents in Cambodia 
were stepping up their campaign against the new anti-Communist 
Cambodian government of Lt. Gen. Lon Nol, and Phnom Penh, the 
Cambodian capital, was soon isolated. On 1 April the Viet Cong and 
North Vietnamese forces began to clear a corridor ten to fifteen miles 
wide along the border all the way from the Gulf of Thailand to the 


102 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


Fish Hook region north-northwest of Saigon, threatening III and IV 
Corps Zones in South Vietnam. 

Responding to these threats, the allied forces decided to openly 
assist the new Cambodian government. In mid-April ARVN forces 
conducted a limited cross-border raid near the Parrot’s Beak region, 
south of the Fish Hook region. At the same time U.S. and ARVN 
staffs started planning for a joint operation against several enemy 
sanctuaries in Cambodia, especially in the Fish Hook region, and on 
28 April President Nixon approved the final plan. From early May to 
the end of June elements of several large U.S. combat units in South 
Vietnam—the 1st Infantry Division, the 1st Cavalry Division, and 
the 11th Armored Cavalry Regiment—took part in these joint strikes 
at suspected Viet Cong bases over the border. USAF B-52 tactical 
bomb strikes and large-scale U.S. helilifts and helicopter gunship 
strikes prepared the way for the ground forces. 

Dust Off and Medevac helicopters supported both South Viet¬ 
namese and American soldiers in this operation. During May the 1st 
Cavalry’s Air Ambulance Platoon supporting the attack flew 1,042 
missions (307 in Cambodia) and evacuated 1,600 patients (946 from 
Cambodia). The dense jungle and forests along the border resulted in 
eighty hoist missions for 182 patients. Although constituting only 7.6 
percent of the total missions for May, hoist missions accounted for 53 
percent of the ships hit by enemy fire that month. In May four ships 
were destroyed and eleven damaged. Ten crewmen were wounded 
and one killed. In June deeper penetrations into Cambodia increased 
flying time for the pilots and crews, even while the number of mis¬ 
sions declined as the fighting tapered off. The crews flew 682 missions 
(199 in Cambodia) and evacuated 1,056 patients (397 from Cam¬ 
bodia). They also extracted 185 patients in ninety-one hoist missions. 
The 45th Medical Company and the 159th Medical Detachment 
helped the Air Ambulance Platoon by backhauling many patients to 
hospitals around Saigon. Because the Viet Cong had been warned of 
the foray and had fled the area, casualties were far below the April 
estimates. What had loomed as a severe test for the Dust Off system 
proved to be largely routine work, except for the dangerous hoist mis¬ 
sions over triple-canopy jungle and forest. 

A Medevac in Peril 

One of these hoist missions during the Cambodian operation 
demonstrated that the air ambulance pilots had no monopoly on 
heroism among the U.S. Army medical personnel in Vietnam. On 
the morning of 24 May 1970 a helicopter of the Air Ambulance Pla¬ 
toon was ferrying S. Sgt. Louis R. Rocco, the medical adviser of a 
MACV advisory team stationed at Katum. Since December 1969 


FROM TET TO STAND-DOWN 103 

Sergeant Rocco had served as liaison to the 1st ARVN Airborne Divi¬ 
sion’s medical battalion. He had trained ARVN personnel on mission 
requests, use of the hoist, the forest penetrator, and the semi-rigid lit¬ 
ter, and he also had presented classes on basic first aid. Whenever 
his duties allowed him the time, Rocco rode the medical helicopters 
on live missions to help the medical corpsmen and to practice some 
“hands on” medicine himself. 

At 1100 on 24 May, Medevac 2 with Sergeant Rocco on board 
flew toward its base at Katum, in northern Tay Ninh province along 
the Cambodian border. A request for a pickup came in through the 
radio of a command-and-control helicopter flying overhead. The call 
was on behalf of eight urgent patients of the 1st ARVN Airborne 
Division. Two of the division’s companies, the 61st and 63d, were on 
a sweep operation five miles inside the Cambodian border. The day 
before, the two companies had made contact with a North Viet¬ 
namese force that broke off and withdrew. The commander of the 
61st Company had the small task force dig in for the night. The 
enemy attacked at dawn on the twenty-fourth but was repulsed by the 
defenders. In pursuing the North Vietnamese the ARVN soldiers 
took eight casualties. The U.S. advisers to the 61st and 63d Com¬ 
panies radioed their evacuation request through Maj. Jesse W. 
Myers, Jr., senior battalion adviser, who was overhead in a 
command-and-control helicopter. 

The pilot of Medevac 2, 1st Lt. Stephen F. Modica, radioed that 
he would take the mission as soon as he dropped off a load of supplies. 
At Katum, the crew threw the beer and sodas onto the pad, grabbed 
an extra chest protector for Rocco, and took off again. Regulations of 
the 1st Cavalry required gunship cover for evacuation missions if a 
unit had been in contact with the enemy within the past twenty-four 
hours. Usually C Battery, 2d Battalion, 20th Aerial Rocket Ar¬ 
tillery— the “Blue Max”—provided this cover by orbiting a team of 
two AH-IG Cobras, one high and one at treetop level. Medevac 2 
had already learned from the U.S. adviser with the ARVN companies 
that the last contact had been to the north two hours earlier. Soon the 
Blue Max gun team arrived on station; Modica briefed them on the 
situation and said he would shoot his approach from the south. When 
the helicopter dropped to the landing zone. North Vietnamese hidden 
in the trees and along the ridge line opened fire with small arms and 
automatic weapons. The lower gunbird opened fire at the muzzle 
flashes in the trees. On its second pass it used its grenade launcher; 
the enemy redirected some of its fire and the gunship took its first hit. 
On its next run it again took enemy fire. 

Just before the Medevac landed, two enemy rounds hit Modica in 
the chest protector and one passed through his left knee and lodged 
against the femur. As soon as the aircraft bumped down, the copilot 


369-454 0 -82 


8 


104 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


turned to kid Modica that he ought to practice his landings. When he 
saw Modica’s wounds, he took the controls and pulled the ship out of 
the landing zone. The aircraft rose fifty feet into the air before the 
engine stalled and the aircraft crashed back to the ground. Major Myers 
later described what he saw from above in his command-and-control ship: 
“The [Medevac] ship seemed to land, then shot up in the air, and then fell 
to the ground rolling over on its side, thrashing around like a wounded in¬ 
sect.... Smoke was pouring out of the ship by this time—” The two gun- 
ships made low firing passes to give the Medevac crew a chance to get out, 
if any still lived. One Cobra gunship came to a high hover over the burning 
Medevac, spinning and firing at the North Vietnamese. The gunship took 
twenty-nine hits before its ammunition ran out, forcing it to 
depart. The pilot transmitted a Mayday for the downed Medevac, 
giving its location and identification, and then called Medevac 
Operations to repeat the information. 

All the Medevac crew were stunned at first and unable to move. 
Finally Rocco dragged himself out and crawled away. He had a frac¬ 
tured wrist and hip and a severely bruised back. As soon as he real¬ 
ized that the crew was still inside, he went back. He pulled Modica 
through the shattered windshield and carried him across twenty 
meters of exposed terrain to the ARVN perimeter. One by one he 
brought the unconscious crew out. All were in bad shape. Modica had 
his serious leg wound. The copilot, 1st Lt. Leroy G. Cauberreaux, 
had a broken collar bone and fractured ribs. Sp5c. Terry Burdette, 
the medical corpsman, had a broken shoulder and a broken leg. The 
gunner, Sp4c. Gary Taylor, who sat in the right door, was crushed 
and burned when the ship crashed and rolled, and Rocco severely 
burned his hands trying to find him. The nearby ARVN soldiers 
could not help because the enemy was shooting at anyone who 
moved. The two bullets that hit Gauberreaux in the chest protector as 
Rocco carried him toward the ARVN perimeter did no further 
damage. Rocco had saved his three comrades from certain death. 

At Quan Loi, the Air Ambulance Platoon’s base, Gapt. Henry O. 
Tuell III, aircraft commander of Medevac 1, yelled to his pilot, 1st Lt. 
Howard Elliot, that Modica had been shot down. Elliot was in the 
shower; he grabbed a towel and ran to get his clothes, scattering soapy 
lather as he went. By the time he had thrown his clothes on, Tuell had 
already cranked the aircraft; off they flew, Elliot lacing boots and 
fastening zippers. Although several other aircraft were in the area, 
Medevac 1 was the first evacuation ship on the scene. Medevac 2 was 
still burning, throwing off blankets of black smoke. Medevac 1 made 
its approach straight in and the enemy tried for another score. On 
each side of Medevac 1 two Gobras fired flechettes, machine guns, 
grenades, and rockets; but enemy rounds still hit the ship. One came 
through the left door and hit the armored seat just below Tuell’s hand. 


FROM TET TO STAND-DOWN 


105 

Shrapnel and shattered porcelain from the seat peppered his hand and 
wrist. Elliot took the controls and nursed the ship back to Quan Loi 
where a doctor cleaned, stitched, and dressed Tuell’s injuries. 

Two hours later, after several air and artillery strikes around the 
perimeter, the pilot of Medevac 12, Lt. John Read, had his gunship 
escort lay down a heavy rocket preparation as he tried a highspeed, 
low-level approach to Medevac 2. The North Vietnamese, still safely 
bunkered behind 1 14 feet of concrete, blasted Medevac 12 out of the 
area before it could land. Bullets punctured the fuel cells and disabled 
the engine. With his tachometer falling, Lt. Read managed to land 
his ship safely in a nearby clearing, where the crew was immediately 
picked up. 

Back at the crash site Modica remained conscious despite loss of 
much blood, and talked to the aircraft orbiting helplessly overhead. 
The American adviser with the ARVN forces, S. Sgt. Louis Clason, 
told him that the ARVN soldiers had not been resupplied in two days 
and were running out of everything, including water. Modica told 
him, “Hey, listen. We have one case of beer in the tail boom of the air¬ 
craft. You run out there —at least that’s something to drink.” Clason 
told him, “Lieutenant, you don’t even know what your aircraft looks 
like. It is burned completely to the ground.” About 1800, Modica 
radioed the nearby aircraft that the ARVN defenders might not be 
able to hold on through the night. After an hour of continuous friend¬ 
ly shelling around the allied perimeter, Medevac 21, piloted by CWO 
Raymond Zepp and covered by gunships, made the third attempt to 
reach the downed aircraft. The Cobra fired a 360 ° pattern with 
rockets and miniguns, but enemy fire still riddled the Medevac, 
knocking out its radios and starting an electrical fire. Like Medevac 
12, Medevac 21 landed in a field 500 meters to the west; its crew was 
quickly pulled out. Nightfall prevented any further rescue attempts. 

During the long hours of darkness, the enemy launched three 
assaults on the small perimeter. Flares overhead illuminated the area 
and allowed the Americans to call in artillery and gunships to break 
up the ground attacks. By nightfall Rocco’s injuries had immobilied 
him. After pulling his crew from the burning ship, he had treated 
their injuries and the ARVN casualties he could get to. Soon his in¬ 
jured hip and hand stiffened, making any effort to move excruciating¬ 
ly painful. Finally he passed out. Modica’s leg swelled to twice its nor¬ 
mal size and the pain immobilized him too. Cauberreaux moved 
about and lit cigarettes for the men, but with his crushed right side he 
could do little else. Since they had no morphine or other painkiller, 
they had to suffer. 

At Quan Loi, planning for an all-out rescue attempt continued 
well into the night. The plan called for two Medevacs to go in and 
evacuate Modica’s crew and any South Vietnamese possible. A third 


106 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


would hover nearby to extricate the crews if trouble developed and to 
evacuate any remaining ARVN casualties. Since all their Medevacs 
were shot up, destroyed, or committed elsewhere, the 1st Cavalry had 
to borrow three nondivisional Dust Off helicopters. At 0930 next 
morning ARVN and American howitzer batteries started laying a 
barrage of smoke rounds in the area to create a screen for the upcom¬ 
ing rescue. Just before the operation began, four Cobras fired more 
smoke rounds. At 1145 the flight of three Medevacs with three cobras 
on each side started into the area. The first ship in loaded Modica and 
his crew and flew out. The second extracted several ARVN wounded 
and also safely left the area. An enemy rocket hit the third ship as it 
took off with two remaining ARVN casualties, but the crew brought 
the ship down without further injuries and was quickly rescued. The 
next day nine pilots and crewmen involved in this rescue received 
Silver Stars. Sergeant Rocco won a Medal of Honor for his part in 
saving Modica and most of his crew. 


Laos 

By October 1970 allied intelligence clearly showed two very 
disturbing facts. After recovering from the setback inflicted by the 
allied attack in Cambodia, the enemy was making plans to strangle 
Phnom Penh, depose the Lon Nol government, and reopen their 
southern supply routes by retaking the port of Kompong Som on the 
Gulf of Thailand. Also, the North Vietnamese Army was improving 
its road nets in Laos, building up supplies, and sending rein¬ 
forcements, all apparently in preparation for large-scale offensives in 
I Corps Zone. Starting in early January 1971 the U.S. XXIV Corps 
and the South Vietnamese Joint General Staff began planning for a 
preventive strike on the enemy bases and lines of communication be¬ 
tween the northwest border of I Corps Zone and the Laotian city 6f ■ 
Muang Xepon. In keeping with President Nixon’s Vietnamizatlion 
program, the South Vietnamese Army was to supply the ground com¬ 
bat forces while the United States supplied air and artillery support. 
U.S. forces were forbidden to set foot on Laotian soil. 

Laos turned into Dust Offs greatest test in the Vietnam war. 
The complexity and offensive character of the operation presented the 
allies a new problem: the helicopter transport and evacuation of large 
forces in rapidly changing tactical situations. From 8 February 
through 9 April 1971 U.S. aircraft, including Air Force B“52’s and 
some 650 Army helicopters, transported ARVN troops into Laos, 
gave them covering fire, and evacuated their wounded and dead. The 
U.S. units involved were reinforced contingents from the 101st Air¬ 
borne Division (Airmobile), 5th Infantry Division (Mechanized), and 


FROM TET TO STAND-DOWN 


107 


23d (“Americal”) Infantry Division. All operated under the command 
of Headquarters, XXIV Corps. The offensive accomplished one ob¬ 
jective: it delayed the enemy at least several months. But it showed 
that even with U.S. support the ARVN forces lacked the leadership to 
prevent heavy losses —approximately 50 percent casualties. 

The ARVN part of this joint, four-phased operation was called Lam 
Son 719; the U.S. part, Dewey Canyon II. Between 30 January and 7 
February the allies were to clear western Quang Tri Province and the 
east-west Route 9 as far west as the Laotian border, establishing forward 
U.S. bases at the abandoned Khe Sanh combat base and fire support 
base Vandegrift. In Phase II between 8 February and 6 March the South 
Vietnamese would cross the border into Laos, establish fire support 
bases, and press on to Muang Xepon. During the next three days, or 
Phase III, the South Vietnamese would locate and destroy enemy caches 
and installations in and around Muang Xepon. In Phase IV all forces 
would gradually withdraw from Laos either along Route 9 or along a 
more southern route. 

All of this information was so tightly held for security reasons that 
medical planners were unaware of the impending operation until the last 
few days of January. Finally the XXIV Corps Surgeon, the senior 
medical adviser in I Corps Zone, and the commander of the ARVN 71st 
Medical Group received a partial briefing on the objectives and plan of 
execution. They set to work immediately, realizing that plans for 
medical support had to be hastily drawn up. Fortunately, both the 
ARVN and U.S. medical units had stockpiled considerable reserves of 
supplies in anticipation of a 1971 Tet offensive. Because of the paucity of 
information, casualty estimates had to be extremely rough. In fact, 
because of the minimal resistance expected from the supposedly 
rearguard enemy troops in the area, first predictions were for low 
casualties. 

After the first briefings, the 67th Medical Group immediately began 
to give South Vietnamese units additional training in the use of U.S. 
medical evacuation. The ARVN interpreters assigned to work with the 
Dust Off crews were given as much training as the week’s busy schedule 
permitted. After the 1st Brigade, 5th Infantry Division, completed its 
two-pronged drive west to Khe Sanh, it dug in at that base with two 101st 
Airborne Eagle Dust Off helicopters standing by. Khe Sanh served as the 
forwardmost site of medical support for the eleven U.S. battalions work¬ 
ing between there and the border. The Dust Off helicopters also stood 
ready to assist the forty-two South Vietnamese maneuver battalions 
assigned to the operation. Dust Off helicopters backhauled U.S. 
casualties to the 18th Surgical Hospital at Quang Tri once they were able 
to travel. Two other Dust Off aircraft stationed at the 18th were to cover 
the land north to the Demilitarized Zone and west to the base named 
Rock Pile on Route 9. All four of these ships were committed to area sup- 


108 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


port. On 5 February the 67th Medical Group put a liaison officer at the 
18th Surgical to respond better to the needs of the U.S. forces. 

Meanwhile the ARVN medical service set up its hospital eight 
kilometers south of Khe Sanh at Bach Son. The South Vietnamese set 
up tents and excavated bunkers. The facilities included two operating 
rooms, an X-ray room, and fifty underground beds. The main Viet¬ 
namese hospital for Lam Son 719 was near the coast, at Dong Ha, at 
the intersection of Routes 1 and 9. 

The Laotian operation presented the problem of suddenly coor¬ 
dinating aeromedical evacuation units whose work so far had usually 
been at scattered sites and, especially in the detachments, under only 
tenuous control by superior organizations. Because of the dangers of the 
missions and the direct involvement of most of the resources of two air 
ambulance detachments—the 237th and the 571st —Col. Richard E. 
Bentley, commander of the 61st Medical Battalion and aviation staff of¬ 
ficer of the 67th Medical Group, ordered that either the commander or 
operations officer of the 571st be physically present at the Khe Sanh 
operations bunker to help regulate both the 237th and 571st. This order 
stood until the difficulty of controlling both fixed and rotary-wing aircraft 
and coordinating them with artillery strikes, bombing, and ground 
maneuvers finally forced the XXIV Corps to request the 67th Medical 
Group for operational control of the two detachments. The 67th con¬ 
sented. The XXIV Corps assigned operational control of the detach¬ 
ments to the 326th Medical Battalion of the 101st Airborne, which then 
controlled the operations of all evacuation helicopters at Khe Sanh and 
Quang Tri. Two other MEDCOM Dust Off units, the 236th Detach¬ 
ment and the 498th Medical Company, also furnished general support 
for northern I Corps and helped backhaul patients from the 18th Surgical 
Hospital at Quang Tri and the 85th Evacuation Hospital at Phu Bai to 
the 95th Evacuation Hospital at Da Nang. 

When Phase II of the operation began, two MEDCOM Dust Offs 
joined the Medevacs and Eagle Dust Offs camped at Khe Sanh to 
support the invasion. Two of the four ships were put under the opera¬ 
tional control of the 101st Combat Aviation Group, primarily to cover 
combat assaults and pull downed crews from Laos. The U.S. medical 
staff quickly set up a few standard procedures for the incursion. Since 
no U.S. advisers would accompany the ARVN ground troops into 
Laos, all medical evacuation missions across the border had to have 
an ARVN interpreter on the aircraft. Once the heavy enemy antiair¬ 
craft defenses in Laos became apparent, the staff decided that gun- 
ships would have to cover the air ambulances once they crossed the 
border. Finally, all evacuation requests would have to pass through a 
tactical operations center, preferably that of the ARVN I Corps, 
rather than go directly to the aircraft commanders. 

During the first three weeks of the operation, the air ambulance 


FROM TET TO STAND-DOWN 


109 


crews complained vociferously. The larger concept of the operation 
had not been made clear to them, and the lack of gunship cover, the 
poor communications, and the false information on area security and 
casualties suggested to them that the operation was a mess. The fur¬ 
ther the South Vietnamese penetrated into Laos, the more intense 
became the antiaircraft fire and the indirect fire on the landing zones. 
As Phase II drew to a close, however, some of the operating pro¬ 
cedures smoothed out. Dust Off representatives now sat in the divi¬ 
sional tactical operations centers; ground commanders overcame 
much of their reluctance to talk with helicopters; and gunship cover 
became routinely available. Coordination of divisional and nondivi- 
sional air ambulances improved markedly once the evacuation re¬ 
quests were funneled to a single Dust Off operations center at Khe 
Sanh. 

Efficiency suffered most of all from the bad weather. The area east 
of the mountains was still in the winter monsoon season. At the same 
time, the weather at Khe Sanh and to the west would often be flyable. 
Since it was on a high plateau, Khe Sanh itself often required instru¬ 
ment flight while the nearby areas were under visual flight rules. 
Often an aircraft took off from Khe Sanh in the late afternoon, flew a 
pickup from Laos, and then had to fly all the way back to Quang Tri 
to land because of poor visibility and low ceilings at Khe Sanh. On 
twenty-four of forty-four days of the Laos operation, low ceilings and 
reduced visibility delayed flight schedules. On some days there were 
no flights at all because of the weather. 

Efficiency also suffered from the poor arrangements for 
backhauls. During Phase I of the operation, patients at Khe Sanh 
were placed on fixed-wing resupply ships for medically unattended 
flights south to Da Nang or Tan Son Nhut. But this practice was not 
sanctioned and ceased early. On 12 February at the request of the 
Surgeon of the U.S. XXIV Corps, the 101st Combat Aviation Group 
began furnishing two CH-47’s each day to backhaul routine cases 
from the ARVN hospital at Bach Son. But this was inadequate; Dust 
Off aircraft at Khe Sanh still had to backhaul emergency cases to 
Dong Ha. As casualties mounted, the backhauls impaired Khe Sanh’s 
ability to respond rapidly to requests for field evacuation. The 
medical system had control of too few aircraft to discharge all of its 
responsibilities. 

Poor coordination of gunship support also became a key obstacle to 
air ambulance missions. On 24 February, mission response time rose 
to seven hours because of delayed gunship protection. Finally, after 
several complaints by the air ambulance crews, the 101st Airborne 
and the XXIV Corps agreed to dedicate some gunships to air am¬ 
bulance coverage. When an air ambulance launched from Khe Sanh, 
the 101st Combat Aviation Group had gunships primed to go with it; 


110 DUST off: army AEROMEDICAL evacuation in VIETNAM 

two teams were on standby during the day and one at night. The 
101st Group also had a fire team positioned at Dong Ha for Dust Off 
protection. But gunship support for all the missions into Laos was still 
impossible, since there were not enough gunships available to satisfy 
all the high priority combat and medical missions. The problem con¬ 
tinued until 25 February, when the XXIV Corps gave Dust Off the 
highest priority for gunship support regardless of the tactical situation 
or other requests. Even so, the enemy antiaircraft fire was so intense 
and the flight routes so restricted by weather and geography that 
many Dust Off crews resumed the old practice of flying all missions in 
pairs, to allow one crew to immediately recover its downed teammate. 

North Vietnamese intelligence had given the enemy ample time to 
deploy an extensive, well integrated, and highly mobile air defense 
system throughout the Xe Pon area of Laos. Many enemy antiaircraft 
weapons were radar-controlled, and Dust Off pilots monitoring their 
VHF radios came to recognize the “wheep wheep” of the radar sweeps 
and take evasive action. But the North Vietnamese had spread some 
750 medium caliber antiaircraft machine guns along Route 9 and the 
valley of the Xe Pon River leading west to Muang Xepon. The North 
Vietnamese relocated most of their antiaircraft weapons daily, mak¬ 
ing their detection and destruction a difficult task. 

The North Vietnamese also placed mortar, artillery, and rocket 
fire on every potential landing zone. Each zone was assigned a heavily 
armed team of ten to twelve men. Every airmobile operation, in¬ 
cluding what normally were single ship Dust Off missions, had to be 
worked out and coordinated, with fire support, armed escort, and a 
recovery plan. As soon as a mission request came in, a command- 
and-control ship, gunships, and the air ambulance would crank and 
launch. This medical evacuation package would rendezvous near the 
Laotian border and fly across. En route to the pickup, the command 
ship helped with navigation and steered the group around the antiair¬ 
craft sites. As it neared the destination, the air ambulance would 
thread its way through a corridor of friendly artillery, tactical air sup¬ 
port, and gunships. While the ambulance was on final approach, on 
the ground, and departing, the gunships would circle overhead, giv¬ 
ing nearly continuous protective fire. After the pickup, the group flew 
a different corridor back to Khe Sanh. 

Papa Whiskey 

One Dust Off mission during the Laos operation illustrated both 
its chaotic finale and the bravery of a Dust Off crewman. On 18 
February a North Vietnamese regiment assaulted fire support base 
Ranger North, nine kilometers inside Laos. About 1130 the South 
Vietnamese 39th Ranger Battalion holding the base asked the Dust 


FROM TET TO STAND-DOWN 


111 


Off operations center at Khe Sanh to evacuate its many seriously 
wounded. A Dust Off aircraft, with a crew from both the 237th and 
571st Detachments, took off and headed west. On their first attempt 
to land they took such heavy fire that the commander, CW2 Joseph 
G. Brown, aborted his approach. A second time around he tried a high 
speed descent and made it in. Just before the ship touched down the 
enemy opened fire again and continued firing while the crew loaded the 
wounded Rangers. Uninjured Rangers trying to escape the base also 
poured into the ship, and Brown had trouble lifting it off. Just as he 
cleared the ground, a mortar round exploded in front of the cockpit, 
shattering the console and wounding him. The ship crashed. Rangers 
scattered from the wreck and the Dust Off crew dragged Brown to a 
ditch for temporary shelter. Leaving him with his pilot, CW2 
Darrel O. Monteith, the crew chief and two medical corpsmen started 
running toward a bunker. A mortar round exploded and blew one 
corpsman, Sp4c. James C. Costello, to the ground. His chest protec¬ 
tor had saved his life, and he stood up, shaken but uninjured. The 
same explosion blew shrapnel into the back and left shoulder of the 
crew chief, Sp4c. Dennis M. Fujii. A second mortar round wounded 
the other corpsman, Sp4c. Paul A. Simcoe. The three men staggered 
into the bunker. 

Shortly before 1400 an Eagle Dust Off ship tried to rescue them, 
but automatic weapons fire drove it off, wounding its pilot. At 1500 
another Eagle Dust Off ship landed under heavy gunship cover. The 
wounded Dust Off crew, except for Fujii, raced to the Eagle ship. A 
mortar barrage falling around it kept him pinned in his bunker, 
where he waved off his rescuers. To escape the enemy fire the Eagle 
pilot had to take off, leaving Fujii as the sole American on the fire 
base, which was now surrounded by two North Vietnamese 
regiments. Another Dust Off ship soon arrived to pick up Fujii, but 
enemy fire forced it to return to Khe Sanh. 

At 1640 Fujii found a working PRC-25 radio and started broad¬ 
casting, using the call sign “Papa Whiskey.” He told the pilots high 
overhead that he wanted no more attempts to rescue him because the 
base was too hot. Using what medical knowledge he had picked up, 
he began tending to the wounded Rangers who surrounded him. 

That night one of the North Vietnamese regiments, supported by 
heavy artillery, started to attack the small base. For the next seven¬ 
teen hours Papa Whiskey was the nerve center of the allied outpost, 
using his radio to call in and adjust the fire of U.S. Air Force AC-130 
flare ships, AC-119 and AC-130 gunships, and jet fighters. Working 
with the Air Force’s forward air controllers, he coordinated the six 
flareships and seven gunships that were supporting Ranger North. 
Twice during the night the enemy breached the perimeter, and only 
then did Fujii stop transmitting to pick up an M16 and join the fight. 


112 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


With the Ranger commander’s permission, Fujii brought the friendly 
fire to within twenty meters of the base’s perimeter, often leaving the 
safety of his bunker to get a closer look at the incoming friendly 
rounds. He worked all night and into the next morning, bringing in 
more than twenty coordinated gunship assaults. 

The next afternoon an all-out rescue attempt began. A fleet of 
twenty-one helicopters descended on the base, the gunships firing on 
every possible enemy position. With Fujii also calling in artillery 
strikes, the allies ringed the camp with continuous fire. Even so, 
hostile fire was so intense that the commander of the rescue fleet, Lt. 
Col. William Peachey, prepared to send down a single ship rather 
than risk a formation. Fujii asked that as many of the 150 ARVN 
casualties as possible be evacuated before him, but Peachey ordered 
him to jump on the first ship that landed. Maj. James Lloyd and 
Capt. David Nelson left the formation, descended into the valley, 
then flew up a slope to the fire base, hugging the trees, and dropped in 
unharmed. Fujii scrambled on board with fourteen Rangers. Having 
recovered from their surprise, the enemy opened fire on the ship as it 
lifted off. Raked with bullets, it caught fire and the cockpit filled with 
smoke. The pilots headed toward Ranger South, fire base of the 21st 
Ranger Battalion about four kilometers southwest. They landed and 
everyone jumped from the burning ship as its M60 rounds started to 
cook off in the flames. Miraculously, no one was injured. Ranger 
South itself soon came under heavy enemy attack, but Fujii’s work 
was over. Finally, at 1600 on 22 February, 100 hours after he was 
wounded, he was admitted to the 85th Evacuation Hospital at Phu 
Bai. He had helped save 122 Rangers. He was quickly awarded a 
Silver Star, which was later upgraded to a Distinguished Service 
Cross. 

Fujii’s mission was only part of an operation that had turned into 
an embarrassing scramble to safety. According to the after action 
report of the 61st Medical Battalion: “During the last phases of Oper¬ 
ation Lam Son 719 enemy activity further intensified. Landing zones 
were dangerously insecure. Air Ambulances landing to pick up 
wounded were swarmed with fit and able soldiers seeking a way out of 
their increasingly precarious position. Medical evacuation pilots 
reported complete lack of discipline during the last days of the opera¬ 
tion coupled with extremely hazardous conditions.” Evacuation ships, 
and indeed any aircraft landing near the South Vietnamese units, 
were rushed by throngs of able-bodied soldiers trying to escape. One 
Eagle Dust Off ship, a UH-IH with a normal load of eleven 
passengers, landed for a pickup and had to take off almost immediate¬ 
ly because of small arms fire and mortar rounds in the landing zone. 
After the pilot set his ship down in Khe Sanh, his crew counted thirty- 
two ARVN soldiers on board, all without weapons or equipment, on- 


FROM TET TO STAND-DOWN 


113 


ly one of whom was wounded. To prevent ARVN soldiers from hitch¬ 
ing a ride back on the sides of the aircraft, some crews resorted to 
coating the skids with grease. 

By early April the Dust Off and Medevac ships had saved hun¬ 
dreds of lives. In the two-month operation they flew some 1,400 mis¬ 
sions, evacuating 4,200 patients. Six crewmen were killed and four¬ 
teen wounded. Ten air ambulances were destroyed, about one out of 
every ten aircraft lost in the operation. On 8 April, once the incursion 
was over, XXIV Corps gave up its operational control of the MED- 
COM air ambulances. Dust Off pilots had seen their last major 
operation of the war. 


Stand-Down and Ship Out 

The phased withdrawal of American forces from Vietnam, begun 
in the summer of 1968, continued until, on 11 August 1972, the last 
American ground combat unit stood down at Da Nang. The 
American venture in this small, remote Asian country had come full 
circle. More than seven years earlier, on 8 March 1965, the first U.S. 
ground combat forces had landed on these same beaches. In 
December 1961 the first U.S. military units, two helicopter com¬ 
panies, had arrived in Saigon to aid the South Vietnamese govern¬ 
ment. It had been the longest war in United States history, and 
almost half of it had been devoted to the withdrawal. 

The drawdown of medical support paralleled that of combat 
forces, but lasted a little longer because of continuing medical needs 
of noncombat U.S. forces in Vietnam. In the early months of 1972 
MEDCOM air ambulances decreased from forty-eight to thirty, leav¬ 
ing five detachments: the 57th, 159th, 237th, 247th, and 571st. In 
June 1972 the Air Ambulance Platoon of the 1st Cavalry stood down, 
leaving all air ambulance missions to the few remaining nondivisional 
Dust Off units. In February 1973 three of the last four Dust Off 
detachments —the 237th, 247th, and 571st —stood down. In February 
the 57th Detachment, the first to arrive in Vietnam and whose early 
commander, Maj. Charles Kelly, had created the Dust Off mystique, 
prepared to become the last to leave, closing down its operations at 
Tan Son Nhut. On 11 March it flew the last Dust Off mission in Viet¬ 
nam, for an appendicitis case. 

After they turned in their aircraft on 14 March, the few remaining 
members of the 57th had little to occupy their time. Some simply took 
pleasure in building their sun tans. A few tried to readjust their daily 
rhythms to Stateside time; they reset their clocks and began to live at 
their home hours, though this meant getting up in the dark and sleep¬ 
ing part of the day. Every now and then they had to check on their 
departure date, but no one demanded any work of them. On 28 


114 DUST off: army AEROMEDICAL evacuation in VIETNAM 

March they received orders to move to Camp Alpha, the personnel 
staging facility at Tan Son Nhut, where they were restricted to the 
compound pending their flight out. Finally, at 0100 on the twenty- 
ninth, they boarded buses for a ride to their C-141 transport. The 
drivers halted the buses some fifty feet from the floodlighted jet, and 
kept the bus doors closed while a double file of people formed between 
the bus and the boarding stairs. The two lines were composed of 
Americans, South Vietnamese, North Vietnamese, and Viet Cong, 
all members of the Four Power Joint Military Commission that was 
supervising the implementation of the peace treaty. 

The bus door opened, and one at a time the departing personnel 
of the 57th marched through this double file. They had been part of 
the last U.S. Army operational personnel in South Vietnam. The 
same day the Military Assistance Command, Vietnam, lowered its 
flag and ceased to function for the first time since 1962. The ground 
war in Vietnam was completely in the hands of the Republic of Viet¬ 
nam for the first time in twenty-seven years. During a long, cruel, 
and ultimately losing struggle. Dust Off personnel had comported 
themselves with courage and honor, proving that a band of brave and 
dedicated pilots and crewmen could make this new mode of medical 
evacuation work extremely well, even against well-prepared enemy 
ground fire. 


Epilogue 

The Vietnam War had its precedents in American military 
history. At the turn of this century the U.S. Army in the Philippines, 
only a few years after the end of its trials during the Indian Wars of 
the American frontier, again fought an enemy that often used guer¬ 
rilla tactics. In 1898 many American soldiers serving in Cuba suffered 
the torments of tropical disease. World War II in the Pacific, although 
conventional in nature, once more subjected American soldiers to the 
hardships of warfare in the tropics. But advances in weapons and 
military transport made the Vietnam War a virtually new experience 
for the American armed forces. 

This was especially true for the Army Medical Department. Its 
experiences with patient evacuation in the Korean War had only 
foreshadowed the problems it would confront in South Vietnam. 
Helicopter ambulances in Korea had rarely needed to fly over enemy- 
held areas, and the terrain of Korea, although rugged, lacked the 
thick jungles and forests that obstructed the air ambulances in Viet¬ 
nam. While Army hospitals in Korea had been highly mobile, moving 
often with the troops, the frontless war in Vietnam resulted in a fixed 
location for almost all hospitals. French armed forces had used the 
helicopter for medical evacuation in their unsuccessful struggle in In¬ 
dochina, but since they had used aircraft that were soon obsolete, 
their experiences could offer little guidance to the Americans who ar¬ 
rived in Vietnam in 1962. 


Statistics 

Records produced by the various U.S. Army air ambulance units 
in Vietnam show that the Medical Department’s new aeromedical 
evacuation system performed beyond all expectation. Although 
figures are lacking for some phases of the system’s work, enough 
reports have survived to permit an assessment of what it accom¬ 
plished. It is possible both to describe the number and types of pa¬ 
tients transported and to compare the risks of air ambulance missions 
with those of other helicopter missions in the Vietnam War. 

Air ambulances transported most of the Army’s sick, injured, and 
wounded who required rapid movement to a medical facility, and also 
many Vietnamese civilian and military casualties. From May 1962 
through March 1973 the ambulances moved between 850,000 and 


116 DUST off: army AEROMEDICAL evacuation in VIETNAM 

900,000 allied military personnel and Vietnamese civilians. The Viet¬ 
namese, both civilian and military, constituted about one half of the 
total; U.S. military personnel, about 45 percent; and other non- 
Vietnamese allied military, about 5 percent. These proportions 
varied, however, over the course of the war. Before 1965 about 90 
percent of the patients were Vietnamese. Then the U.S. buildup 
began in 1965, and the figure dropped to only 21 percent for 1966. As 
the United States started to turn over more of the fighting to the South 
Vietnamese, the number rose until it reached 62 percent in 1970. Un¬ 
fortunately, exact percentages of wounded, injured, and sick among 
the air ambulance patients are lacking. Although only about 15 per¬ 
cent of the cases treated by all Army medical personnel in the war 
were wounded in action, it seems that the percentage of wounded 
among the air ambulance patients was much higher, between 30 and 
35 percent, since the ambulances gave first priority to patients in im¬ 
mediate danger of loss of life or limb, a condition most closely 
associated with combat wounds. Up to 120,000 of the U.S. Army 
wounded in action admitted to some medical facility —90 percent of 
the total —were probably carried on the ambulances. This is about 
one third of the some 390,000 Army patients that the air ambulances 
carried to a medical facility. 

The widespread use of the air ambulances clearly seems to have 
reduced the percentage of deaths from wounds that could have been 
expected if only ground transportation were used. In World War II 
the percentage of deaths among those Army soldiers admitted to a 
medical facility was 4.5; in Korea, 2.5. In Vietnam it was 2.6, despite 
a road network as bad as that in Korea, despite thick jungle and forest 
that made off-the-road evacuation much more difficult than in Korea, 
and despite the large numbers of hopeless patients whom the air am¬ 
bulances brought to medical facilities just before they died. Another 
statistic —deaths as a percentage of hits—shows more clearly the im¬ 
provement in medical care: in World War II it was 29.3 percent; in 
Korea, 26.3 percent; and in Vietnam, only 19 percent. Helicopter 
evacuation was only one aspect of the Army’s medical care in Viet¬ 
nam, but without that link between the battlefield and the superbly 
staffed and equipped hospitals, it seems likely that the death rate 
would have surpassed perhaps even that in World War II. 

Measured both by the patients moved and the number of missions 
flown, the air ambulances were busiest in 1969, when by the end of 
the year 140 were stationed around the country. Over the course of 
the war the divisional air ambulances of the 1st Cavalry and 101st 
Airborne constituted only 15 percent of the total. Because of the 
high maintenance demands of the UH-1, only about 75 percent of the 
ambulances were flyable at any given moment, although replacement 
aircraft could sometimes be borrowed from helicopter maintenance 


EPILOGUE 


117 


companies. Of the aviators required by the Army tables of organiza¬ 
tion and equipment, an average of 90 percent was available for duty. 
Although at times the air ambulances were filled to capacity and even 
overcrowded, a single mission on the average moved only two pa¬ 
tients. In the peak years of U.S. involvement, from 1965 to 1969, a 
single mission averaged, round trip, about fifty minutes. In the same 
period the ambulance units used the hoist only once every sixty mis¬ 
sions. The helicopters averaged about two missions per workday in 
1965, increasing to four missions in 1969. 

Statistics also confirm the impression that the air ambulance pilots 
and crewmen stood a high chance of being injured, wounded, or killed in 
their one-year tour. About 1,400 Army commissioned and warrant of¬ 
ficers served as air ambulance pilots in the war. Theirs was one of the 
most dangerous types of aviation in that ten-year struggle. About forty 
aviators (both commanders and pilots) were killed by hostile fire or 
crashes induced by hostile fire. Another 180 were wounded or injured as 
a result of hostile fire. Furthermore, forty-eight were killed and about 
two hundred injured as a result of nonhostile crashes, many at night and 
in bad weather on evacuation missions. Therefore, slightly more than a 
third of the aviators became casualties in their work, and the crew chiefs 
and medical corpsmen who accompanied them suffered similarly. 
The danger of their work was further borne out by the high rate of air 
ambulance loss to hostile fire: 3.3 times that of all other forms of 
helicopter missions in the Vietnam War. Even compared to the loss 
rate for nonmedical helicopters on combat missions it was 1.5 times as 
high. Warrant officer aviators, who occasionally arrived in South 
Vietnam without medical training or an assignment to a unit, were 
sometimes warned that air ambulance work was a good way to get 
killed. 

One air ambulance operation, the hoist mission, added greatly to 
these dangers. Although hoist missions were rarely flown, one out of 
every ten enemy hits on the air ambulances occurred on such occa¬ 
sions. Standard missions averaged an enemy hit only once every 311 
trips, but hoist missions averaged an enemy hit once every 44 trips, 
making them seven times as dangerous as the standard mission. That 
some 8,000 aeromedical hoist missions were flown during the war fur¬ 
ther testifies to the bravery of the air ambulance pilots and crewmen. 

Doctrine and Lessons Learned 

When the first Army air ambulances arrived in Vietnam in April 
1962, none of the existing Army guidelines for aeromedical evacua¬ 
tion fitted their needs. Only in August 1963 did the 57th Medical 
Detachment receive a mission statement, in the form of USARV 
Regulation 59-1 (12 August 1963). It contained a list of patient 


118 DUST off: army AEROMEDICAL evacuation in VIETNAM 

priorities, based on nationality and civilian-military status. It pro¬ 
hibited the use of the air ambulances for nonmedical administrative 
and logistical purposes, and it outlined the steps to be taken by 
ground commanders in making a request for an air ambulance. As 
the war progressed, the regulation was updated periodically to cover 
various emerging problems. By the end of the war it was twice as long 
as the August 1963 version, and it elaborated on several problems 
that had been ignored or treated only briefly in the original —hoist 
operations, evacuation of the dead, pickup zones reported as in¬ 
secure, and misclassification of patients. A new category of patient 
had been designated: tactical urgent, meaning that the evacuation 
was urgent not because of the patient’s wound but because of im¬ 
mediate enemy danger to the patient’s comrades. The old categories 
of urgent, priority, and routine were now defined at length. An ap¬ 
pendix and a diagram outlined the requesting unit’s responsibilities in 
preparing a pickup zone. Little was left to the ground commander’s 
imagination. 

In spite of this amplification for the benefit of the ground com¬ 
mander, much was still left to the interpretation of the air ambulance 
commanders and pilots. Controversies over the use of the air am¬ 
bulances that had surfaced early in the war were at its end untreated 
and unresolved by any Army regulation or field manual. 

One of these problems concerned the best type of organization for 
air ambulance units. In an article in the August 1957 issue of Medical 
Journal of the United States Armed Forces, Col. Thomas N. Page and Lt. 
Col. Spurgeon H. Neel, Jr., had outlined current Army doctrine on 
aeromedical evacuation. One of their precepts read: “The company- 
type organization for the aeromedical function is superior to the cur¬ 
rent cellular detachment concept.” But the first two aeromedical 
evacuation units that deployed to Vietnam were detachments that 
depended on nearby aviation units for their mess and other logistical 
needs, and for part of their maintenance. Although two TOE air am¬ 
bulance companies, the 45th and 498th, were eventually deployed, 
most of the air ambulances in the war worked in cellular detachments. 

After the war several former aviation consultants to the 
Surgeon General stated that the company structure had provided ad¬ 
ministrative and logistical advantages that outweighed its disadvan¬ 
tages. Most former detachment commanders and some of the former 
company commanders, however, emphasized the weakness of the 
company structure. Because of the dispersed nature of the fighting in 
Vietnam, the platoons of the companies often were field-sited far from 
their company headquarters, creating a communication problem and 
also reducing the effectiveness of the company’s organic maintenance 
facilities that were located at the home base. The detachments, 
however, had their own limited maintenance facilities, and the pla- 


EPILOGUE 


119 


toons organic to an airmobile division could readily draw on its 
resources. For about one year toward the end of the war an experi¬ 
ment with two medical evacuation battalions had produced encourag¬ 
ing results, but the experiment apparently was too limited to firmly 
establish the battalion as the ideal medical evacuation unit. No formal 
statement from the Surgeon General had resolved the issue by the end 
of the war: a policy of flexibility seems to have evolved by default, 
allowing the use of whatever type of organization best fitted the 
geographic region and phase of the war. 

In 1957 Page and Neel had also written: “The consensus is that 
there is no real requirement for a separate communications net for the 
control of aeromedical evacuation.” But the air ambulance units in 
Vietnam quickly found that tactical command networks were often 
too busy to permit their use by medical personnel. In September 1966 
the commander of the 3d Surgical Hospital wrote: “Casualty control 
and medical regulating of patient load would be well served by a 
separate radio net exclusive to the medical service. Accurate 
knowledge of incoming loads of patients would allow proper notifica¬ 
tion of hospital personnel and preparation of critical supplies in ad¬ 
vance. Multiple switchboards and untrustworthy landlines now pre¬ 
vent the dissemination of information which might aid in the optimal 
care of patients.” Shortly thereafter the USARV regulation on 
aeromedical evacuation was amended to assign the air ambulance 
units two frequencies, one for use in I and II Corps Zones and one for 
III and IV Corps Zones. 

In another area. Page and Neel had outlined a point of Army 
medical doctrine that remained, despite some complaints by combat 
commanders, inviolate throughout the war: “Within the Army, the 
Army Medical Service has the basic technical responsibility for all 
medical evacuation, whether by surface or aerial means .... The Ar¬ 
my Medical Service requires sufficient organic aviation of the proper 
type to enable it to accomplish its continuing mission of rapid evacu¬ 
ation of the severely wounded directly to appropriate medical treat¬ 
ment facilities.” The Medical Service received its helicopters in the 
buildup from 1965 through 1969, and most of the aviators who served 
as air ambulance commanders, whether commissioned or warrant of¬ 
ficers, had received medical training comparable to that given a bat¬ 
talion surgeon’s assistant. Only in the first years of the war were the 
detachments under the operational control of nonmedical aviation 
units. Medical control of air evacation did not preclude having 
nonmedical aviation units evacuate large numbers of patients with 
only routine wounds, injuries, and illnesses. Page and Neel had writ¬ 
ten: “The Army Medical Service does not require sufficient organic 
aviation for the entire Army aeromedical evacuation mission .... The 
movement of nonemergency patients by air can be accomplished 


369-454 0-82 


9 


120 DUST off: army AEROMEDICAL evacuation in VIETNAM 

economically by making use of utility and cargo aircraft in conjunc¬ 
tion with normal logistic missions, provided there is adequate medical 
control over the movement of patients.” The twenty-four air am¬ 
bulances of the 1st Cavalry and 101st Airborne Division also re¬ 
mained outside the jurisdiction of the Army medical command in 
Vietnam. Even so, all officer and most warrant officer ambulance 
pilots of the divisions had to pass the Medical Service Corps training 
program for ambulance pilots; and when the division pilots flew pa¬ 
tients directly to a hospital, they were required to radio a 44th 
Medical Brigade regulating officer for approval of their destination. 

While some combat commanders objected to medical control over 
evacuation of their casualties, others resented their inability to subor¬ 
dinate the Dust Off air ambulances to a mission of close and direct 
support for their particular unit. Although there was usually a con¬ 
siderable difference in rank between the aircraft commander of a Dust 
Off ship and the irritated ground commander, there apparently were 
few instances of the commander succeeding in obtaining direct sup¬ 
port without first routing his request through prescribed channels. 
Throughout the war most Army commanders knew that casualties 
properly classified as urgent would almost always benefit from 
evacuation in an air ambulance. 

One subject not touched upon by Page and Neel proved to be a 
source of lasting trouble in Vietnam. While the three basic patient 
classifications —routine, priority^ and urgent—survived in the Army 
regulation until the end of the war, no agreement could be reached on 
the proper definition of these terms. Most of the controversy dealt 
with the category “priority,” which as originally worded applied to a 
patient who required prompt medical care not available locally and 
who should be evacuated within twenty-four hours. In practice, the 
aeromedical units found that this definition often resulted in 
overclassification of priority patients as urgent patients, who were ex¬ 
pected to be moved immediately. Most ground commanders simply 
would not take the responsibility of saying that any of their wounded 
could wait up to twenty-four hours for medical treatment. When the 
air ambulance units proposed shortening the time limit on priority pa¬ 
tients, some staff officers noted that in practice the ambulances were 
picking up priority patients as soon as possible and that almost no 
priority patient ever had to wait twenty-four hours for evacuation. So 
USARV headquarters changed the regulation to read: “Priority: Pa¬ 
tients requiring prompt medical care not locally available. The 
precedence will be used when it is anticipated that the patient must be 
evacuated within four hours or else his condition will deteriorate to 
the degree that he will become an urgent case.” Even after this 
amendment, the regulation drew criticism from Maj. Patrick Brady, 
who argued that there should be only two categories: urgent and 


EPILOGUE 


121 


nonurgent. He thought that all missions should be flown as urgent, 
resources permitting, and that the requestor should be allowed to set 
his own time limit on nonurgent patients. 

This controversy arose partly from the tension between those 
aviators who, preserving the Kelly tradition, paid scant attention to 
the security of the landing zone, the weather, or the time of day in 
deciding whether to accept a mission, and those units and aviators 
who adopted a cautious approach. The USARV regulation and the 
published operating procedures of some of the units favored the more 
cautious approach, calling for gunship escorts on all hoist missions, 
discouraging night missions except for urgent patients, and pro¬ 
hibiting flight into an insecure pickup zone. Night, bad weather, and 
reports of recent enemy fire in a pickup zone would keep the cautious 
pilots from even lifting off on a mission. But none of these would pre¬ 
vent the bolder pilots from making an immediate liftoff, even for a 
routine patient. Little short of enemy fire would keep the braver 
pilots, once they were above the landing zone on an urgent or priority 
mission, from going in. On an urgent mission, a few pilots like Major 
Kelly, Major Brady, and Mr. Novosel, would even fly into the teeth 
of enemy bullets to get to wounded. The bolder pilots also adhered 
closely to the section of the Geneva convention that required all air 
ambulances to carry no weapons. Although almost all the pilots took 
along sidearms, many declined the use of gunship escorts or external¬ 
ly mounted M60 machine guns. 

The tension between these two approaches to air ambulance work 
could hardly have been resolved by any command edict, and no at¬ 
tempt was made to do so. The USARV regulation left the ultimate 
decision on whether to reject or abort a mission entirely in the hands 
of the individual aircraft commander who received the request. On 
Brady’s first tour in Vietnam, one of his comrades told him that if he 
kept on taking so many risks he would either be killed or win the 
Medal of Honor. Consciously preserving the Kelly tradition, and 
drawing on his vast store of skill and luck, Brady survived and indeed 
won the nation’s highest military award. Most of the pilots, while not 
quite measuring up to the Kelly tradition, acted bravely and 
honorably enough to win widespread respect and gratitude from those 
who served in Vietnam. 

A Historical Perspective 

What did the Dust Off experience mean to the history of medical 
evacuation? The concepts developed in Maj. Jonathan Letterman in 
1862 —medically controlled ambulances and an orderly chain of 
evacuation that takes each patient no farther to the rear than 
necessary—are still sound. There will always be a hierarchy of 


122 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


medical facilities in wartime: the more specialized the care, the more 
likely it will be infrequently used, and centralized at a point well to 
the rear of a battlefront, often completely outside the war zone. 
Modern technology has made it possible to improve enormously the 
quality and range of care provided at hospitals in or near a war zone, 
especially in the area of lifesaving equipment and techniques. But the 
more complicated demands of restorative and recuperative care will 
probably long remain a duty of medical facilities in the communica¬ 
tions zone and the zone of the interior. Helicopter evacuation and 
modern medical technology have only modified, not destroyed, the 
value of Letterman’s system, particularly in medical care close to the 
scene of battle. 

Because helicopter ambulances usually kept a combat unit within 
a half hour’s flight time from an allied base in Vietnam, it was no 
longer necessary to set up the traditional hierarchy of medical facili¬ 
ties—a Letterman chain of evacuation. Battalion aid stations and 
division clearing stations found many of their old duties assumed by 
immobile and often distant surgical, field, and evacuation hospitals, 
where most patients, except those in remote areas such as the Central 
Highlands, were flown directly from the site of wounding. The speed 
of the helicopter ambulances combined with a proficient medical 
regulating system after 1966 allow the larger hospitals to specialize in 
certain types of wounds. Despite these advantages, the simplification 
of the Letterman chain of evacuation also had its dangers. At times, 
as during the battle around Dak To in 1967, the nearest hospitals able 
to take casualties might be too far away to permit direct flights from 
the battlefield. In times of large-scale casualties, such as the Tet offen¬ 
sive of 1968, central medical facilities unsupported by the triage and 
surgical services of lower echelon medical facilities, even if there were 
adequate warning, could find themselves overwhelmed. Sometimes, 
as during the strike into Laos in 1971, faulty casualty estimates could 
result in a local shortage of medical helicopters. Furthermore, the less 
seriously wounded patients of an air ambulance, especially those not 
requiring major surgery, could often find themselves evacuated far¬ 
ther to the rear than necessary. 

Whether the modification of the Letterman system that occurred 
in Vietnam saves money —by specializing wound care, fixing the 
location of most surgically equipped hospitals, and reducing the care 
furnished at the division clearing stations and some of the smaller 
surgical hospitals—is debatable, given the attendant need to upgrade 
the larger hospitals in the combat zone and expand the expensive 
helicopter evacuation system. A more important question is whether 
the modification improves medical care and saves lives. The Dust Off 
story suggests that it did help reduce the Army’s mortality rate in 
Vietnam. But it is doubtful whether that experience, in an 


EPILOGUE 


123 


undeveloped country and in a war against an enemy with few effec¬ 
tive antiaircraft weapons, would prove wholly applicable in a large- 
scale conventional conflict in a more developed theater. In such a con¬ 
flict there might be a role for truly mobile surgical hospitals, which 
were not used in Vietnam. Working close to the front, such hospitals 
would be within range of both ground and air ambulances. The ideas 
of Jonathan Letterman would still merit the closest attention. 


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Bibliographical Note 

For sources the authors relied mainly on records produced by air 
ambulance units in Vietnam. Those records that have not yet been 
transferred to the National Archives, Record Group 112, Office of the 
Surgeon General, are stored in the Washington National Records 
Center, Suitland, Maryland. 

Captain Dorland interviewed fifty-three people who took part in 
Dust Off operations in Vietnam. Dr. Nanney, in the final stages of 
preparing the manuscript, especially Chapter 4, interviewed the avia¬ 
tion consultant to the Surgeon General, Lt. Col. Thomas C. Scofield. 
Tapes of these interviews are available at the Center of Military 
History. 

Most of the authors’ sources were official records, but several ar¬ 
ticles, books, and official studies proved useful. 


Articles 

Binder, James L. “Dean of the Dust-Offers.” Trmjv 21 (August 1971): 
16-21. 

Brady, Patrick H. “Dust Off Operations.” Army Logistician 5 (July- 
August 1973): 18-23. 

_. “Instruments and Flares.” United States Army Aviation Digest 15 

(January 1969): 12-13. 

_. “Solo Missions.” United States Army Aviation Digest 12 

1966): 2-6. 

Breese, J.E. “Rotors over the Jungle: No. 848 Naval Air Squadron in 
Malaya.” Flight, 12 March 1954, pp. 291-92. 

Clark, D.M. “Helicopter in Air Evacuation.” The Air Surgeon’s Bulletin. 

Cooling, B. Franklin. “A History of U.S. Army Aviation.” Aerospace 
Historian 21 (June 1974): 102-09. 

Decker, Bill. “Medic.” Army Digest 22 (July 1967): 27-29. 

Eiseman, B. “The Next War: A Prescription.” JJnited States Naval In¬ 
stitute Proceedings 101 (January 1975): 33-40. 

Farrell, Robert. “Special Report from Algeria, Part I: French Meet 
Guerrillas with Helicopters.” Week, 17 September 1956, 

pp. 28-31. 

_. “Special Report from Algeria, Part II: Algerian Terrain 

Challenges Helicopters.” Aviation Week, 24 September 1956, pp. 
88-92. 





126 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


Goodrich, Isaac. “Emergency Medical Evacuation in an Infantry Bat¬ 
talion in South Vietnam.” Military Medicine 132 (October 1967): 
796-98. 

Haldeman, Steve. “Jungle Medevac.” Army Digest 24 (August 1969): 
44-45. 

Harvey, E. Bruce. “Casualty Evacuation by Helicopter in Malaya.” 

British Medical Journal, 1 September 1951, pp. 542-44. 

Hasskarl, Robert A., Jr. “Early Military Use of Rotary Wing Air- 
cra.h.’^ Airpower Historian 12 (July 1965): 75-77. 

Hessman, James D. “U.S. Combat Deaths Drop 90 Percent as Viet- 
namization Takes Hold.” Armed Forces Journal 109 (April 1972): 
42-44. 

Lam, David M. “From Balloon to Black Hawk.” A four-part series. 

United States Army Aviation Digest 27 (June-September 1981). 
Lawrence, G.P. “The Use of Autogiros in the Evacuation of Wound¬ 
ed.” The Military Surgeon, December 1933, pp. 314-21. 

“Missile! Missile! Missile!” United States Army Aviation Digest 2\ (April 
1975): 30. 

Modica, Stephen F. “Medevac Meadow.” United States Army Aviation 
Digest 21 (June 1975): 4-5. 

_. Letter to the Editor. United States Army Aviation Digest 21 

(June 1975): 22-23. 

Monnier, R., and G. Wernert. “Etat actuel de evacuations sanitaires 
par helicopteres—Indochine.” Societe de Medecine Militaire, no. 4 
(April 1956), pp. 116-23. 

Neel, Spurgeon H. “Aeromedical Evacuation.” Army 6 (April 1956): 
30-33. 

_. and Roland H. Shamburek. “The Army Aviation Story: 

Part IX, Medical Evacuation.” United States Army Aviation Digest 9 
(February 1963): 33-41. 

_. “Dustoff: When I Have Your Wounded.” United States Army 

Aviation Digest 20 (May 1974): 6-9. 

_. “Helicopter Evacuation in Korea.” United States Armed Forces 

Medical Journal 6 (May 1955): 691-702. 

_. “Medical Considerations in Helicopter Evacuation.” United 

States Armed Forces Medical Journal 5 (February 1954): 220-27. 
Page, Thomas N., and Spurgeon H. Neel, Jr., “Army Aeromedical 
Evacuation.” United States Armed Forces Medical Journal 8 (August 
1957): 1195-1200. 

Riley, David. “French Helicopter Operations in Algeria.” Marine 
Corps Gazette, February 1958, pp. 21-26. 

“Safety for Combat Readiness.” United States Army Aviation Digest 15 
(August 1969): 37-44. 

Salvagniac, Surgeon General. “Les Evacuations Sanitaires Aerien- 
Revue Historique De LArmee, no. 1 (1972): 230-53. 







BIBLIOGRAPHICAL NOTE 


127 


Scoles, Peter S. “Forward Medical Service of the Future.” Military 
Review 41 (April 1961): 64-70. 

Scotti, Michael J. “Out of the Valley of Death.” United States 
Army Aviation Digest 16 (May 1970): 12-14. 

Smith, Allen D. “Air Evacuation —Medical Obligation and Military 
Necessity.” The United States Atr Force Atr University Quarterly 
Review 6 (Summer 1953): 98-111. 

-Medical Air Evacuation in Korea and Its Influence on the 

Future.” The Military Surgeon 110 (May 1952): 323-32. 

Smith, William H. “Honor Times 29.” United States Army Aviation 
Digest 20 (January 1974): 3-5. 

“Treetop Whirlybird Nest.” Army 15 (November 1965): 20-22. 

“Up and Out.” United States Army Aviation Digest 9 (September 1963): 
13-16. 

Wiegman, Curtis M. “To Save a Life.” United States Army Aviation 
Digest 18 (August 1972): 56-59. 

Williams, Charles. “Operations of the 1st Helicopter Ambulance 
Company.” American Helicopter 32 (November 1953): 8. 

Williams, Robert C. “Survivor Wishes to Meet Helicopter—Object: 
Survival.” United States Army Aviation Digest 14 (May 1968): 55-59. 


Books and Studies 

Battelle Columbus Laboratories. Journal of Defense Research: Series B 
(Tactical Warfare). Vol. 7B, No. 3 (Fall 1975): Tactical Warfare 
Analysis of Vietnam Data. Especially Chapter XI: “United States 
Casualties Analyzed.” 

Bonds, Ray, ed. The Vietnam War: The Illustrated History of the Conflict in 
Southeast Asia. New York: Crown, 1979. 

Collins, James L., Jr., Brig. Gen. The Development and Training of the 
South Vietnamese Army, 1950-1972. Department of the Army: Viet¬ 
nam Studies. Washington, D.C.: Government Printing Office, 
1975. 

Department of Defense. “Report on Selected Air and Ground Opera¬ 
tions in Cambodia and Laos.” 10 September 1973. Army War 
College Library. Carlisle Barracks, Pa. 

Kahin, George M., and John W. Lewis. The United States in Vietnam. 
New York: Delta, 1967. 

Link, Mae Mills, and Hubert A. Coleman. Medical Support of the Army 
Air Forces in World War II. Office of the Surgeon General, United 
States Air Force. Washington, D.C.: Government Printing Of¬ 
fice, 1955. Especially Chapter V: “Air Evacuation Missions,” pp. 
352-412. 



128 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


Littauer, Raphael, and Norman Uphoff, eds. The Air War in In¬ 
dochina. Air War Study Group, Cornell University. Revised edi¬ 
tion. Boston: Beacon, 1972. 

Neel, Spurgeon, Maj. Gen. Medical Support of the U.S. Army in Vietnam, 
1965-1970. Department of the Army: Vietnam Studies. 
Washington, D.C., Government Printing Office, 1973. 

Politella, Dario. Operation Grasshopper: The Story of Army Aviation in Korea 
from Aggression to Armistice. Wichita, Kansas: Robert Longto, 1958. 

Stewart, Miller J. Moving the Wounded: Litters, Cacolets, and Ambulance 
Wagons, U.S. Army, 1776-1876. Ft. Collins, Co.: Old Army Press, 
1979. 

Tierney, Richard, and Fred Montgomery. The Army Aviation Story. 
Northport, Alabama: Colonial Press, 1963. Especially Chapter 
VI: “Medical Evacuation.” 

Tolson, John J., Lt. Gen. Airmobility, 1961-1971. Department of the 
Army: Vietnam Studies. Washington, D.C.: Government Prin¬ 
ting Office, 1973. 

Weinert, Richard P. A History of Army Aviation, 1950-1962. Phase I: 
1950-1954. Fort Monroe, Virginia: U.S. Continental Army 
Command Historical Office, 1971. 

Westmoreland, William C., General. A Soldier Reports. Garden City, 
N.Y.: Doubleday, 1976. 


Index 


Accidents, 81 
AC VO Corporation, 69 
Aerial Rocket Artillery, 20th, 103 
Aeromedical evacuation. See also Medical 
evacuation, 
early days of, 6-10 
and Korean War, 4, 10-20, 115 
Air ambulance detachments. See Helicopter 
Detachments (Korea); Medical 
Detachments (Helicopter Ambulance). 
Air Ambulance Platoons 

1st Cavalry Division, 45-49, 69, 85, 
91-92, 95, 102-103, 113, 116, 120 
101st Airborne Division, 94-95, 107, 112, 
116, 120 

Air ambulance platoons 
origins of, 44-46 
performance of, 46-49 
Air Assault I, 45 

Air Assault Division (Test), 11th, 45 
Air Force, U.S., 10-11, 60-61, 83-84, 

97, 111 

Airborne Brigade, 173d, 49, 54, 57, 59-61 
Airborne Corps, XVIII, 70 
Airborne Division, 101st, 50, 83, 91-92, 
106, 109 
Aircraft 

C-47 Dakotas, 28-29 
T-28, 23 

Airmobile Company, 114th, 35 
Ambulances, air. See also Helicopter 
ambulances, 
autogiro, 8 
Cox-Klemin XA-1, 8 
DeHavilland DH-4A, 7, 8 
shortages of, 46, 55, 90 
Ambulances, ground, 4-6 
AN/APX-44 transponder, 82 
An Khe plain, 46-48 
Ap Bac, 27-28 

Armed Forces Radio Station, Saigon, 28 
Armored Cavalry Regiment, 11th, 102 
Army, Eighth, 13, 19 
Army Aviation Digest, 82, 84 
Army Support Group, Vietnam (USASGV), 
26, 27, 28, 33, 39 
Army Unit, 8193d, 14 
Assault Helicopter Battalion, 173d, 69 
Autorotation, 68, 73 


Aviation Companies 
73d, 35 
117th, 51 

Aviation Group, 164th, 91 
Aviation School, U.S. Army, 46 

Bac Lieu, 35 
Bach Son, 108-109 
Backhauling, 8, 60, 102, 107-109 
Ballinger, Maj. William, 81-82 
Bell Aircraft Corporation, 15-16, 19, 

50, 67, 71 

Bentley, Col. Richard E., 108 
Berry, Capt. Walter L., Jr., 49 
Bien Hoa, 73 
Binh Gia, 40-41 
Binh Thuy, 99 

Bloomquist, Maj. Paul A., 38, 62 
Blunt, Lt. Col. James W., 52 
Bobay, Maj. CarlJ., 49 
Bowler, Lt. Joseph, 15 
Brady, Maj. Patrick H., 34, 38, 120-121 
and Medal of Honor, 61-66 
and night missions, 82-84 
Breeze Corporation, 71 
Brink Hotel, Saigon, 28 
Brooke Army Medical Center, Texas, 19 
Brown, Lt. Col. James M., 16 
Brown, CW2 Joseph G., Ill 
Buildups, U.S. 

1964, 38-40 

1965-1968, 43-44, 56-57 
Bundy, William P., 41 
Burdette, Sp5c Terry, 104 

Cai Cai, 34 
Call signs 

Dust Off, 29-30, 40 
Eagle Dust Off, 95 
Medevac, 46 
Papa Whiskey, 111 
Ca Mau, 35 

Cambodia incursion, 94, 101-102 
Camp Alpha, 114 
Camp Bullis, Texas, 50 
Camp Eagle, 91 
Camp Evans, 92 
Camp Holloway, 41 
Can Tho, 31, 35, 40 
Cao Van Vien, Gen., 89 


130 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


Capozzi, Maj. Henry P., 39-40 
Cashon, Sgt. Robert E., 63-64 
Casualties, 48, 54, 60-61, 88, 115-116 
Cauberreaux, 1st Lt. Leroy G., 104-105 
Cavalry Division (Airmobile), 1st, 44-48, 
59 

and Air Ambulance Platoon, 69, 85 
and Cambodia incursion, 102, 106 
and Jungle Canopy, 70-71 
and Tet offensive, 91 
Central Highlands, 21-22, 43, 46 
Cercle Hippique, Saigon, 28 
Cercle Sportif, Saigon, 28 
Chamberlain, WOl Tyrone, 96-98 
Chassaing, Dr. Eugene, 7 
Chu Lai, 56, 61-63, 65, 83-84 
Civil War, U.S., and ambulances, 4-6 
Clason, S. Sgt. Louis, 105 
Club Nautique, Saigon, 28 
Combat Aviation Battalion, 52d, 60 
Combat Aviation Group, 101st, 109-110 
Combat Operations Center, U.S.-ARVN, 
40 

Conant, Col. Ralph E., 52 
Corps 

I, 14 

XXIV, 106, 108-109, 113 
Corps Zones 

I, 21, 29, 56 

II, 21, 29, 43, 50-51, 59 

III, 21, 29, 43, 49, 53 

IV, 21-22, 29, 53 
Costello, Sp4c James C., Ill 
Cu Chi, 56 

Cu Lao Re, 62 

Da Nang, 39, 43 
Dak To, 59-61 
Day, Capt. Emil R., 14 
Dead, transportation of by evacuation 
units, 32, 80 

DECCA navigational system, 56, 81 
Density altitudes, 68 
Di An, 73-74 

Distinguished Service Crosses, 37-38, 112 
Divisions. See Air Assault Division; 

Airborne Division; Cavalry Division; 
Infantry Divisions. 

Doctrine, 117-121 
Dong Ha, 108 
Dong Tam, 58 
Dong Xoai, 43 

Dovell, Col. Chauncey E., 10-11 
Dubuy, Lt. Col. Carl T., 11-12 
Dust Off call sign, 29-30, 40 

Eisenhower, Dwight D., 23 
Elliot, 1st Lt. Howard, 104-105 
Enemy fire, 22, 84-87 


Engines (AVCO Corporation) 

Lycoming T-53-L-11, 69, 72 
Lycoming T-53-L-13, 56, 66, 69 
Evacuation chain, 5, 121-123 
Evacuation Hospitals 
67th, 60 
71st, 46, 59-60 
85th, 47, 60, 108, 112 
91st, 90 
93d, 56 
95th, 108 
8054th, 11 
Evacuation missions 

dispatch control of, 54-55 
and night missions, 82-83 
and problems of, 79-84 
standard procedures, 74-79 

Field Force, Vietnam, I, 69 

Field Hospital, 8th, 24-25, 27, 90 

Fischer, Lt. Col. Carl A., 27 

Fish Hook region, 102 

Five Oceans Club, Saigon, 28 

Flares, 83-84 

Forest penetrator, 72-73 

Forsee, Maj. Gen. James H., 24 

Fort Benning, Ga., 44-45, 61 

Fort Bragg, N.C., 55, 70 

Fort Gordon, Ga., 45 

Fort Rucker, Ala., 46 

Fort Sam Houston, Tex., 39, 50, 71 

Fort Stewart, Ga., 45 

Franco-Prussian War, 6 

French Army air ambulances, 4, 7, 115 

Fujii, Sp4c Dennis M., 111-112 

“Gaggle,” 79 

Geneva Conventions, 85-86, 121 
Gia Lam, 3-4 

Goodman, Maj. Dorris C., 92 
Gosman, Capt. George H. R., 6-7 
Gulf of Tonkin, 39 

Hall, Col. Robert M., 58 
Harkins, Gen. Paul D., 26 
Harman, Lt. Carter, 9 
Harness, rescue, 72 
Harris, Maj. Gen. William, 50 
Heinold, Sp4c Herbert, 96-97 
Helicopter ambulance aircraft 
H-5, 10-11 

H-13 Sioux, 11-12, 15-17, 68 
H-34, 31 

Kaman HH-43 “Husky,” 69 
Sikorsky, 8-9 

UH-1 Iroquois (“Huey”), 19, 24, 26-29, 
33, 50, 56, 67-69, 72 
Helicopter ambulance units, 

organization of, 45-46, 49-52, 
100-101, 118-119 


INDEX 


131 


Helicopter ambulances 
crews of, 76-78 
and Korean War, 4, 10-20 
statistics on, 115-117 
and white paint, 86-87 
Helicopter Companies 
18th Aviation, 23 
93d Transportation, 23 
Helicopter Detachments (Korea) 

1st, 11 

2d, 11-13, 15 
3d, 11 
4th, 11, 17 
Helicopters 

H-21 Shawnee, 23, 27 
H-34, 29 

Hely, Capt. Joseph W., 12-13 
Heuter, Capt. Harvey, 91 
Hiep Due Valley, 64 
Hill, Maj. William R., 61 
Hill 875, 59-61 
Ho Chi Minh, 95 

Hoist missions, 69, 70-74, 85, 102, 117 
Hoists, 54, 58, 60, 66 
Horvath, Sp4c Joseph, 96-98 
Howlett, Lt. Col. Byron P., Jr., 61, 94 
Howze, Lt. Gen. Hamilton H., 44 
Howze Board, 44-45 
Hue, 91-92 

Huntsman, Maj. Howard H., 39-40 


la Drang Valley, 48 
Infantry Divisions 
1st, 54, 102 
2d, 45 
3d, 14 
4th, 54, 59 
5th, 106-107 
7th, 12, 17 
9th, 57-58, 91 

23d (Americal), 56, 64-65, 107 
25th, 54 
38th, 9 

Iron Triangle, 17, 26, 54 

Johnson, Lyndon B., 38, 39, 41, 43, 89 
Joint Chiefs of Staff, 38 
Jones, Capt. Lewis, 92 
Jungle Canopy Platform System, 70-71 
Jutlandia, 18 

Kaman Corporation, 72 
Kane, Capt. Charles F., Jr., 47 
Katum, 102-103 

Kelly, Maj. Charles L., 32-39, 61, 

113, 121 

Kennedy, John F., 23 


Khe Sanh 

and Laos incursion, 107-111 
and Tet offensive, 90-92 
Kimsey, Capt. Guy, 46-47 
Kinnard, Brig. Gen. Harry W. O., 45, 48 
Knisely, Lt. Benjamin M., 92-94 
Kompong Som, 106 
Kontum Province, 59 
Korean unit, 28th Regiment, 57 
Korean War, air medical evacuation in, 

4, 10-20, 115 

Lai Khe, 69 

Lanessan Hospital, 3 

Language barrier, 17, 80-81 

Laos incursion, 94, 106-110 

Larrey, Baron Dominique Jean, 4 

Lawrence, Lt. Col. G. P., 8 

Letterman, Maj. Jonathan, 5, 121, 123 

Lincoln, Abraham, 6 

Litters, Stokes, 8, 11, 15-16, 72 

Lloyd, Maj. James, 112 

Logistics, problems of, 25-27 

Logistical Command, 1st, 51, 95 

Lombard, Capt. James E., 73-74 

Lon Nol, Lt. Gen., 101, 106 

Long Binh, 49, 56, 62, 69, 91, 99, 101 

McClellan, Maj. Gen. George B., 5 
McGibony, Col. James T., 24 
McNamara, Robert, 38 
McWilliam, Lt. Col. Robert D., 62-63, 84 
Madrano, Lt. Col. Joseph P., 50-51, 53 
Maintenance problems, 46, 51 
Marine Expeditionary Brigade, 9th, 43 
Medals of Honor, 63-66, 98, 106 
Medevac call sign, 46 

Medical Air Ambulance Squadron, 38th, 8 
Medical Battalions 
4th, 60 
9th, 58 

15th, 45, 48-49 
326th, 108 

Medical Brigade, 44th, 44, 55, 58, 62, 
90-91, 95, 100, 120 

Medical Command, Vietnam (Provisional), 
U.S. Army, 86, 95-96, 99 
Medical Companies (Air Ambulance) 

45th, 53, 55-56, 58, 69, 91, 96, 

102, 118 

436th, 52-54, 55 

498th, 50-52, 55, 56, 60, 62, 69, 90, 

92, 101, 108, 118 
658th, 53 

Medical company (air ambulance), 
organization of, 49-52, 118 
Medical Department, U.S. Army, 4, 6, 

115 


132 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


Medical Detachments (Helicopter 
Ambulance) 

50th, 56-57, 94-95 
53d, 19 

54th, 56, 61-64, 83-84, 100, 101 
57th, 24-25, 28-29, 38, 41, 49, 67, 

79, 85, 117 

and Detachment A, 32-40 
and Dust Off call sign, 29-30 
and Dust Off training for VNAF, 99 
and hoists, 70-71 
and logistics problems, 25-27 
and night missions, 82 
and operational control of, 52-53 
and relations with South Vietnamese, 
30-32 

and Tet offensive, 91 
and two-pilot missions, 76-77 
and withdrawal of, 113-114 
68th, 101 

82d, 39-40, 57, 67, 96 

and Dust Off training for VNAF, 99 
and operational control of, 52-53, 79 
and Tet offensive, 91 
159th, 56, 102, 113 
236th, 101, 108 
237th, 101, 108, 111, 113 
247th, 58, 113 
254th, 49, 53, 56, 74, 80 
283d, 49, 53, 60, 73-74, 101 
436th (Company Hqs), 53, 58 
571st, 56, 92, 101, 108, 111, 113 
Medical evacuation, 3-4 
chain of, 122-123 
early days of, 4-6 

and transportation of the dead, 32, 80 
and Vietnamese Air Force, 25, 30-32, 
98-100 

Medical evacuation battalion, 

organization of, 100-101, 119 
Medical Evacuation Battalions 
58th, 101 
61st, 100-101 

Medical Field Service School, 8 
Medical Groups 
43d, 44, 53, 90, 95 
55th, 44, 62, 90, 95 
67th, 44, 91, 95, 101, 107-108 
68th, 44, 53, 91, 95, 101 
Medical regulating officers, 78 
Medical Service, U.S. Army 
in Korea, 19 
in Vietnam, 25, 44, 119 
in World War II, 8-10 
Medical Service Corps (MSC) pilots, 

20, 37, 44, 49, 51, 67, 120 
Medical Test and Evaluation Activity, 
U.S. Army, 71 

Meyer, Lt. Michael M., 92-94 


Military Assistance Command, Vietnam, 
41, 94, 114 

Miller, Col. Ray L., 55 

Missile, SA-7 heat-seeking (Soviet), 

86-87 

Mobile Army Surgical Hospitals (MASH), 
10-11 
1st, 12 
8076th, 17 
Moc Hoa, 97-98 

Modica, 1st Lt. Stephen F., 103-106 
Monteith, CW2 Darrel O., Ill 
Moore, Lt. Col. Harold G., 48 
Muang Xepon, 106-107 
Myers, Maj. Jesse W., Jr., 103-104 

Nam Can, 35 

National Security Act of 1947, 9-10 
Navigation equipment, 80-81 
Neel, Lt. Col. Spurgeon H., Jr., 20, 
118-120 

Nelson, Capt. David, 112 

Ngo Dinh Diem, 23 

Nguyen Cao Ky, Gen., 38, 43 

Nguyen Khanh, Maj. Gen., 38 

Nguyen Van Thieu, Gen., 43 

Nha Trang, 24-25, 27-28, 51, 56, 69 

Nichols, Capt. Al, 91 

Nixon, Richard M., 95, 102, 106 

Novosel, CW3 Michael J., 96-98, 121 

Okinawa, 26 
O Lac, 31 

Operation Attleboro, 53-55 
Operation Cedar Falls, 54 
Operation Dewey Canyon II, 107 
Operation Long Huu II, 31 
Operation Lam Son 719, 107-108, 112 
Operation Pegasus, 92 
Operation Salem House, 101 
Operation Shiny Bayonet, 47 

Pack, Harry S., 14 
Page, Col. Thomas N., 118-120 
Partridge, Lt. Gen. Earle E., 11 
Patient classifications and priorities, 

75, 117-118, 120-121 
Peachey, Lt. Col. William, 112 
Peers, Maj. Gen. William R., 59 
Percy, Baron Pierre Francois, 4 
Perfume River, 92 
Phan Thiet, 34 
Phnom Kto Mountain, 36 
Phnom Penh, 101 
Phu Bai, 91 
Phu Hiep, 56 
Phu Vinh, 35 
Pierpoint, Robert, 17-18 


INDEX 


133 


Pilots 

Medical Service Corps, 20, 37, 44, 49, 
51, 67 

shortages of, 36-37, 49, 90 
statistics on, 117 

and two-pilot missions, 76-77, 85 
Plain of Reeds, 82 
Plei Me, 47 
Pleiku, 29, 51, 60 
Pleiku Province, 47-48, 59 

Quan Loi, 104-105 
Quang Tri, 107-109 
Qui Nhon, 25, 27-29, 51-52, 60, 81-82, 
100 

Rach Gia, 35 

Radio communications, 13, 66, 78-79, 119 
Ranger North fire support base, 110-111 
Ranger South fire support base, 112 
Read, Lt. John, 105 
Red River Delta, 4 
Regimental Combat Team, 112th, 9 
Regulations, USARV 
59-1, 117-118 
40-10, 99 

Regulators, medical, 78 
Retzlaff, Capt. Donald, 71 
Rex Hotel, Saigon, 28 
Rhoades, Lt. Albert L., 6 
Rice, WOl George W., 49 
Richardson, Sp4c James E., 94 
Riverboat Restaurant, Saigon, 28 
Riverine operations, 57-59 
Rocco, S. Sgt. Louis R., 102-106 
Rocksprings, Tex., 8 
Rostow, Dr. Walt W., 23 
Ruiz, 1st Lt. Melvin J., 73-74 
Rusk, Dean, 43 

Saigon Golf and Tennis Clubs, 28 
Salado Creek Park, Tex., 50 
“Scarfing,” 35 

Schenck, WOl Charles D., 64 
Sebourn, Capt. Albert C., 12-13, 15 
Seminole War of 1835-42, 4 
Shortages 

of air ambulances, 46, 55, 90 
of pilots, 36-37, 49, 90 
Sikorsky, Igor, 8 
Simcoe, Sp4c Paul A., Ill 
Soc Trang, 32-35, 39 
Song Be, 43 

Spanish American War, 6 
Spencer, Maj. Lloyd E., 28-30 
Sputnik fire suppression systems, Kaman, 
45-46 

Standard operating procedures, 74-79 
Stilwell, Brig. Gen. Joseph W., 26-28, 

33, 35, 38-39, 82 


Stratemeyer, Maj. Gen. George E., 9 
Strength, troop, 55, 66, 95 
Suoi Da, 54 

Supply depots. Pacific, 26 
Surgeon, MACV, 99-100 
Surgeon, U.S. Army, 9 
Surgeon, USARV, 50-51, 95-96 
Surgeon General, U.S. Army, 25, 39, 44 
and air ambulance detachments, 19-20 
and Aviation Section, 19, 36, 67, 69 
and hoists, 71 
Surgical Hospitals 
2d, 62 
3d, 91 

18th, 107-108 
27th, 65 

Sylvester, 2d Lt. Ernest J., 34 

Tactical Mobility Requirements Board, 
U.S. Army, 44 

Tan Son Nhut Air Base, 28, 73 
Tan Son Nhut Airport, 49 
Task Force 117, U.S. Navy, 57-58 
Tay Ninh Province, 54 
Taylor, Sp4c Gary, 104 
Taylor, Gen. Maxwell D., 23, 41 
Temperelli, Capt. John, Jr., 24-28 
Tet offensive, .89-94 
Thomas, Brig. Gen. David E., 96 
Tibbetts, Capt. Oscar N., 11 
TO&E 8-500A, 19 
Tombstone, 91 

Training programs, evacuation, for 

South Vietnamese, 67, 98-100, 107 
Transportation Battalion, 15th, 47 
Transportation Companies (Helicopter) 
8th, 23 
57th, 23 
Triage, 5 
True Giang, 35 

Tuell, Capt. Henry O., Ill, 104 
Tuy Hoa, 24 

U.S. Congress, 39 
U.S.N.S. Card, 62 
U.S.S. Colleton, 58-59 
U.S.S. Consolation, 18 
U.S.S. Core, 23 
U.S.S. Montrose, 58 
U.S.S. Nueces, 59 

Vandegrift fire support base, 107 
Viet Cong 

and Cambodia incursion, 101-102 
and Tet offensive, 89-91 
and weapons used, 29, 85-86 
Viet Cong units 
Division, 9th, 40-41, 54 
Regiments, 271st and 272d, 40 


134 


DUST off: army AEROMEDICAL evacuation in VIETNAM 


Vietnam, South, climate and terrain of, 
21-22, 70 
Vietnamese, North 

and Cambodia incursion, 94, 101-102 
and Laos incursion, 106, 110 
Navy of, 39 

and Tet offensive, 92-93 
and units of 
Division, 2d, 64 
Regiment, 32d, 47 
Regiment, 33d, 47-48 
Regiment, 66th, 47-48 
Regiment, 101st, 

Regiment, 174th, 59 
Vietnamese units. South 

Air Force, medical evacuation by, 25, 
30-32, 98-100 
Airborne Division, 1st, 103 
Infantry, 7th, 27 
Marine Battalion, 4th, 41 
Ranger Battalion, 33d, 41 
Ranger Battalion, 39th, 110-111 
Regiment, 14th, 31 
Vietnamese Provincial Hospital, 31 


Vietnamization, 98-100, 106 
Vi Thanh, 35, 57 
Vinh Long, 35, 91 
Vung Tau, 62, 91 

Walker, Lt. Gen. Walton, 10 
Weapons 
U.S., 79, 85 
Viet Cong, 85-86 

Westmoreland, Gen. William C., 41, 43 
48, 55, 89-90 

Weyand, Lt. Gen. Fred, 89 
Wheeler, Gen. Earle G., 26 
Williams, Maj. Glenn, 53 
Withdrawal of U.S. forces, 89, 95, 

113-114 

World War I, and medical evacuation, 6-7 
World War II, and air medical 
evacuation, 8-9 
Wright, Wilbur and Orville, 6 

Xe Pon, Laos, 110 

Zepp, CWO Raymond, 105 


O.S. GOVERNMENT PRINTING OFFICE : 1982 0 - 369-454 : QL 3 


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